Smoke evacuation system including a segmented control circuit for interactive surgical platform

ABSTRACT

Surgical systems can include evacuation systems for evacuating smoke, fluid, and/or particulates from a surgical site. A surgical evacuation system can be intelligent and may include one or more sensors for detecting one or more properties of the surgical system, evacuation system, surgical procedure, surgical site, and/or patient tissue, for example. The surgical system may include a segmented control circuit, a method of operating a segmented control circuit in a surgical evacuation system may include activating a first segment that includes a main processor and a safety processor. The first segment is caused to perform a first function. A second segment is activated where the second segment includes a sensing circuit and a display circuit. A third segment is activated where the third segment includes a motor control circuit and a motor.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of priority under 35 U.S.C. § 119(e)to U.S. Provisional Patent Application Ser. No. 62/691,257, titledCOMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD INSMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM, filed Jun.28, 2018, the disclosure of which is herein incorporated by reference inits entirety.

This application claims the benefit of priority under 35 U.S.C. § 119(e)to U.S. Provisional Patent Application Ser. No. 62/650,887, titledSURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES, filed Mar. 30,2018, to U.S. Provisional Patent Application Ser. No. 62/650,877, titledSURGICAL SMOKE EVACUATION SENSING AND CONTROLS, filed Mar. 30, 2018, toU.S. Provisional Patent Application Ser. No. 62/650,882, titled SMOKEEVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM, filed Mar. 30,2018, and to U.S. Provisional Patent Application Ser. No. 62/650,898,titled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS,filed Mar. 30, 2018, the disclosure of each of which is hereinincorporated by reference in its entirety.

This application also claims the benefit of priority under 35 U.S.C. §119(e) to U.S. Provisional Patent Application Ser. No. 62/640,417,titled TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEMTHEREFOR, filed Mar. 8, 2018, and to U.S. Provisional Patent ApplicationSer. No. 62/640,415, titled ESTIMATING STATE OF ULTRASONIC END EFFECTORAND CONTROL SYSTEM THEREFOR, filed Mar. 8, 2018, the disclosure of eachof which is herein incorporated by reference in its entirety.

This application also claims the benefit of priority under 35 U.S.C. §119(e) to U.S. Provisional Patent Application Ser. No. 62/611,341,titled INTERACTIVE SURGICAL PLATFORM, filed Dec. 28, 2017, to U.S.Provisional Patent Application Ser. No. 62/611,340, titled CLOUD-BASEDMEDICAL ANALYTICS, filed Dec. 28, 2017, and to U.S. Provisional PatentApplication Ser. No. 62/611,339, titled ROBOT ASSISTED SURGICALPLATFORM, filed Dec. 28, 2017, the disclosure of each of which is hereinincorporated by reference in its entirety.

BACKGROUND

The present invention relates to surgical systems and evacuatorsthereof. Surgical smoke evacuators are configured to evacuate smoke, aswell as fluid and/or particulate, from a surgical site. For example,during a surgical procedure involving an energy device, smoke can begenerated at the surgical site.

SUMMARY

The present disclosure provides new and innovative methods and systemsfor a smoke evacuation system including a segmented control circuit foran interactive surgical platform. An example method includes activatinga first segment that includes a main processor and a safety processor.The first segment is caused to perform a first function. A secondsegment is activated where the second segment includes a sensing circuitand a display circuit. A third segment is activated where the thirdsegment includes a motor control circuit and a motor.

An example system includes a control circuit including a plurality ofsegments, including a first segment, a second segment, and a thirdsegment. The first segment includes a main processor and a safetyprocessor, where the main processor is coupled to a memory, and thememory stores instructions executable by the main processor to energizethe first segment before the second and third segment, energizing thesecond and third segments after the first segment performs a firstfunction. The second segment includes a sensing circuit and a displaycircuit, and the third segment including a motor control circuit and amotor.

Additional features and advantages of the disclosed methods and systemsare described in, and will be apparent from, the following DetailedDescription and the Figures.

BRIEF DESCRIPTION OF THE DRAWINGS

The features of various aspects are set forth with particularity in theappended claims. The various aspects, however, both as to organizationand methods of operation, together with further objects and advantagesthereof, may best be understood by reference to the followingdescription, taken in conjunction with the accompanying drawings asfollows.

FIG. 1 is perspective view of an evacuator housing for a surgicalevacuation system, in accordance with at least one aspect of the presentdisclosure.

FIG. 2 is a perspective view of a surgical evacuation electrosurgicaltool, in accordance with at least one aspect of the present disclosure.

FIG. 3 is an elevation view of a surgical evacuation tool releasablysecured to an electrosurgical pencil, in accordance with at least oneaspect of the present disclosure.

FIG. 4 is a schematic depicting internal components within an evacuatorhousing for a surgical evacuation system, in accordance with at leastone aspect of the present disclosure.

FIG. 5 is a schematic of an electrosurgical system including a smokeevacuator, in accordance with at least one aspect of the presentdisclosure.

FIG. 6 is a schematic of a surgical evacuation system, in accordancewith at least one aspect of the present disclosure.

FIG. 7 is a perspective view of a surgical system including a surgicalevacuation system, in accordance with at least one aspect of the presentdisclosure.

FIG. 8 is a perspective view of an evacuator housing of the surgicalevacuation system of FIG. 7, in accordance with at least one aspect ofthe present disclosure.

FIG. 9 is an elevation, cross-section view of a socket in the evacuatorhousing of FIG. 8 along the plane indicated in FIG. 8, in accordancewith at least one aspect of the present disclosure.

FIG. 10 is a perspective view of a filter for an evacuation system, inaccordance with at least one aspect of the present disclosure.

FIG. 11 is a perspective, cross-section view of the filter of FIG. 10taken along a central longitudinal plane of the filter, in accordancewith at least one aspect of the present disclosure.

FIG. 12 is a pump for a surgical evacuation system, such as the surgicalevacuation system of FIG. 7, in accordance with at least one aspect ofthe present disclosure.

FIG. 13 is a perspective view of a portion of a surgical evacuationsystem, in accordance with at least one aspect of the presentdisclosure.

FIG. 14 is a front perspective view of a fluid trap of the surgicalevacuation system of FIG. 13, in accordance with at least one aspect ofthe present disclosure.

FIG. 15 is a rear perspective view of the fluid trap of FIG. 14, inaccordance with at least one aspect of the present disclosure.

FIG. 16 is an elevation, cross-section view of the fluid trap of FIG.14, in accordance with at least one aspect of the present disclosure.

FIG. 17 is an elevation, cross-section view of the fluid trap of FIG. 14with portions removed for clarity and depicting liquid captured withinthe fluid trap and smoke flowing through the fluid trap, in accordancewith at least one aspect of the present disclosure.

FIG. 18 is a schematic of an evacuator housing of an evacuation system,in accordance with at least one aspect of the present disclosure.

FIG. 19 is a schematic of an evacuator housing of another evacuationsystem, in accordance with at least one aspect of the presentdisclosure.

FIG. 20 illustrates a smoke evacuation system in communication withvarious other modules and devices, in accordance with at least oneaspect of the present disclosure.

FIG. 21 depicts an example flow diagram of interconnectivity between thesurgical hub, the cloud, the smoke evacuation module, and/or variousother modules A, B, and C, in accordance with at least one aspect of thepresent disclosure.

FIG. 22 illustrates a smoke evacuation system in communication withvarious other modules and devices, in accordance with at least oneaspect of the present disclosure.

FIG. 23 illustrates one aspect of a segmented control circuit, inaccordance with at least aspect of the present disclosure.

FIG. 24 discloses a method of operating a control circuit portion of thesmoke evacuation module so as to energize the segmented control circuitin stages, in accordance with at least one aspect of the presentdisclosure.

FIG. 25 is a block diagram of a computer-implemented interactivesurgical system, in accordance with at least one aspect of the presentdisclosure.

FIG. 26 is a surgical system being used to perform a surgical procedurein an operating room, in accordance with at least one aspect of thepresent disclosure.

FIG. 27 is a surgical hub paired with a visualization system, a roboticsystem, and an intelligent instrument, in accordance with at least oneaspect of the present disclosure.

FIG. 28 is a partial perspective view of a surgical hub enclosure, andof a combo generator module slidably receivable in a drawer of thesurgical hub enclosure, in accordance with at least one aspect of thepresent disclosure.

FIG. 29 is a perspective view of a combo generator module with bipolar,ultrasonic, and monopolar contacts and a smoke evacuation component, inaccordance with at least one aspect of the present disclosure.

FIG. 30 illustrates individual power bus attachments for a plurality oflateral docking ports of a lateral modular housing configured to receivea plurality of modules, in accordance with at least one aspect of thepresent disclosure.

FIG. 31 illustrates a vertical modular housing configured to receive aplurality of modules, in accordance with at least one aspect of thepresent disclosure.

FIG. 32 illustrates a surgical data network comprising a modularcommunication hub configured to connect modular devices located in oneor more operating theaters of a healthcare facility, or any room in ahealthcare facility specially equipped for surgical operations, to thecloud, in accordance with at least one aspect of the present disclosure.

FIG. 33 illustrates a computer-implemented interactive surgical system,in accordance with at least one aspect of the present disclosure.

FIG. 34 illustrates a surgical hub comprising a plurality of modulescoupled to the modular control tower, in accordance with at least oneaspect of the present disclosure.

FIG. 35 illustrates one aspect of a Universal Serial Bus (USB) networkhub device, in accordance with at least one aspect of the presentdisclosure.

FIG. 36 illustrates a logic diagram of a control system of a surgicalinstrument or tool, in accordance with at least one aspect of thepresent disclosure.

FIG. 37 illustrates a control circuit configured to control aspects ofthe surgical instrument or tool, in accordance with at least one aspectof the present disclosure.

FIG. 38 illustrates a combinational logic circuit configured to controlaspects of the surgical instrument or tool, in accordance with at leastone aspect of the present disclosure.

FIG. 39 illustrates a sequential logic circuit configured to controlaspects of the surgical instrument or tool, in accordance with at leastone aspect of the present disclosure.

FIG. 40 illustrates a surgical instrument or tool comprising a pluralityof motors which can be activated to perform various functions, inaccordance with at least one aspect of the present disclosure.

FIG. 41 is a schematic diagram of a robotic surgical instrumentconfigured to operate a surgical tool described herein, in accordancewith at least one aspect of the present disclosure.

FIG. 42 illustrates a block diagram of a surgical instrument programmedto control the distal translation of a displacement member, inaccordance with at least one aspect of the present disclosure.

FIG. 43 is a schematic diagram of a surgical instrument configured tocontrol various functions, in accordance with at least one aspect of thepresent disclosure.

FIG. 44 is a simplified block diagram of a generator configured toprovide inductorless tuning, among other benefits, in accordance with atleast one aspect of the present disclosure.

FIG. 45 illustrates an example of a generator, which is one form of thegenerator of FIG. 44, in accordance with at least one aspect of thepresent disclosure.

FIG. 46 is a timeline depicting situational awareness of a surgical hub,in accordance with one aspect of the present disclosure.

DETAILED DESCRIPTION

Applicant of the present application owns the following U.S. patentapplications, filed on Jun. 29, 2018, the disclosure of each of which isherein incorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. ______, titled CAPACITIVE        COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS, Attorney        Docket No. END8542USNP/170755;    -   U.S. patent application Ser. No. ______, titled CONTROLLING A        SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE PARAMETERS,        Attorney Docket No. END8543USNP/170760;    -   U.S. patent application Ser. No. ______, titled SYSTEMS FOR        ADJUSTING END EFFECTOR PARAMETERS BASED ON PERIOPERATIVE        INFORMATION, Attorney Docket No. END8543USNP1/170760-1;    -   U.S. patent application Ser. No. ______, titled SAFETY SYSTEMS        FOR SMART POWERED SURGICAL STAPLING, Attorney Docket No.        END8543USNP2/170760-2;    -   U.S. patent application Ser. No. ______, titled SAFETY SYSTEMS        FOR SMART POWERED SURGICAL STAPLING, Attorney Docket No.        END8543USNP3/170760-3;    -   U.S. patent application Ser. No. ______, titled SURGICAL SYSTEMS        FOR DETECTING END EFFECTOR TISSUE DISTRIBUTION IRREGULARITIES,        Attorney Docket No. END8543USNP4/170760-4;    -   U.S. patent application Ser. No. ______, titled SYSTEMS FOR        DETECTING PROXIMITY OF SURGICAL END EFFECTOR TO CANCEROUS        TISSUE, Attorney Docket No. END8543USNP5/170760-5;    -   U.S. patent application Ser. No. ______, titled SURGICAL        INSTRUMENT CARTRIDGE SENSOR ASSEMBLIES, Attorney Docket No.        END8543USNP6/170760-6;    -   U.S. patent application Ser. No. ______, titled VARIABLE OUTPUT        CARTRIDGE SENSOR ASSEMBLY, Attorney Docket No.        END8543USNP7/170760-7;    -   U.S. patent application Ser. No. ______, titled SURGICAL        INSTRUMENT HAVING A FLEXIBLE ELECTRODE, Attorney Docket No.        END8544USNP/170761;    -   U.S. patent application Ser. No. ______, titled SURGICAL        INSTRUMENT HAVING A FLEXIBLE CIRCUIT, Attorney Docket No.        END8544USNP1/170761-1;    -   U.S. patent application Ser. No. ______, titled SURGICAL        INSTRUMENT WITH A TISSUE MARKING ASSEMBLY, Attorney Docket No.        END8544USNP2/170761-2;    -   U.S. patent application Ser. No. ______, titled SURGICAL SYSTEMS        WITH PRIORITIZED DATA TRANSMISSION CAPABILITIES, Attorney Docket        No. END8544USNP3/170761-3;    -   U.S. patent application Ser. No. ______, titled SURGICAL        EVACUATION SENSING AND MOTOR CONTROL, Attorney Docket No.        END8545USNP/170762;    -   U.S. patent application Ser. No. ______, titled SURGICAL        EVACUATION SENSOR ARRANGEMENTS, Attorney Docket No.        END8545USNP1/170762-1;    -   U.S. patent application Ser. No. ______, titled SURGICAL        EVACUATION FLOW PATHS, Attorney Docket No.        END8545USNP2/170762-2;    -   U.S. patent application Ser. No. ______, titled SURGICAL        EVACUATION SENSING AND GENERATOR CONTROL, Attorney Docket No.        END8545USNP3/170762-3;    -   U.S. patent application Ser. No. ______, titled SURGICAL        EVACUATION SENSING AND DISPLAY, Attorney Docket No.        END8545USNP4/170762-4;    -   U.S. patent application Ser. No. ______, titled COMMUNICATION OF        SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR CLOUD IN SMOKE        EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM, Attorney        Docket No. END8546USNP/170763;    -   U.S. patent application Ser. No. ______, titled SURGICAL        EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR COMMUNICATION        BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE, Attorney Docket        No. END8547USNP/170764; and    -   U.S. patent application Ser. No. ______, titled DUAL IN-SERIES        LARGE AND SMALL DROPLET FILTERS, Attorney Docket No.        END8548USNP/170765.

Applicant of the present application owns the following U.S. Provisionalpatent applications, filed on Jun. 28, 2018, the disclosure of each ofwhich is herein incorporated by reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/691,228, titled        A METHOD OF USING REINFORCED FLEX CIRCUITS WITH MULTIPLE SENSORS        WITH ELECTROSURGICAL DEVICES;    -   U.S. Provisional Patent Application Ser. No. 62/691,227, titled        CONTROLLING A SURGICAL INSTRUMENT ACCORDING TO SENSED CLOSURE        PARAMETERS;    -   U.S. Provisional Patent Application Ser. No. 62/691,230, titled        SURGICAL INSTRUMENT HAVING A FLEXIBLE ELECTRODE;    -   U.S. Provisional Patent Application Ser. No. 62/691,219, titled        SURGICAL EVACUATION SENSING AND MOTOR CONTROL;    -   U.S. Provisional Patent Application Ser. No. 62/691,257, titled        COMMUNICATION OF SMOKE EVACUATION SYSTEM PARAMETERS TO HUB OR        CLOUD IN SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL        PLATFORM;    -   U.S. Provisional Patent Application Ser. No. 62/691,262, titled        SURGICAL EVACUATION SYSTEM WITH A COMMUNICATION CIRCUIT FOR        COMMUNICATION BETWEEN A FILTER AND A SMOKE EVACUATION DEVICE;        and    -   U.S. Provisional Patent Application Ser. No. 62/691,251, titled        DUAL IN-SERIES LARGE AND SMALL DROPLET FILTERS.

Applicant of the present application owns the following U.S. Provisionalpatent application, filed on Apr. 19, 2018, the disclosure of each ofwhich is herein incorporated by reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/659,900, titled        METHOD OF HUB COMMUNICATION.

Applicant of the present application owns the following U.S. patentapplications, filed on Mar. 29, 2018, the disclosure of each of which isherein incorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. 15/940,641, titled INTERACTIVE        SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES;    -   U.S. patent application Ser. No. 15/940,648, titled INTERACTIVE        SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES AND DATA        CAPABILITIES;    -   U.S. patent application Ser. No. 15/940,656, titled SURGICAL HUB        COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM        DEVICES;    -   U.S. patent application Ser. No. 15/940,666, titled SPATIAL        AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS;    -   U.S. patent application Ser. No. 15/940,670, titled COOPERATIVE        UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES BY        INTELLIGENT SURGICAL HUBS;    -   U.S. patent application Ser. No. 15/940,677, titled SURGICAL HUB        CONTROL ARRANGEMENTS;    -   U.S. patent application Ser. No. 15/940,632, titled DATA        STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE        ANONYMIZED RECORD;    -   U.S. patent application Ser. No. 15/940,640, titled        COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERS AND        STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED        ANALYTICS SYSTEMS;    -   U.S. patent application Ser. No. 15/940,645, titled SELF        DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT;    -   U.S. patent application Ser. No. 15/940,649, titled DATA PAIRING        TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN OUTCOME;    -   U.S. patent application Ser. No. 15/940,654, titled SURGICAL HUB        SITUATIONAL AWARENESS;    -   U.S. patent application Ser. No. 15/940,663, titled SURGICAL        SYSTEM DISTRIBUTED PROCESSING;    -   U.S. patent application Ser. No. 15/940,668, titled AGGREGATION        AND REPORTING OF SURGICAL HUB DATA;    -   U.S. patent application Ser. No. 15/940,671, titled SURGICAL HUB        SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER;    -   U.S. patent application Ser. No. 15/940,686, titled DISPLAY OF        ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE;    -   U.S. patent application Ser. No. 15/940,700, titled STERILE        FIELD INTERACTIVE CONTROL DISPLAYS;    -   U.S. patent application Ser. No. 15/940,629, titled COMPUTER        IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;    -   U.S. patent application Ser. No. 15/940,704, titled USE OF LASER        LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF        BACK SCATTERED LIGHT;    -   U.S. patent application Ser. No. 15/940,722, titled        CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF        MONO-CHROMATIC LIGHT REFRACTIVITY; and    -   U.S. patent application Ser. No. 15/940,742, titled DUAL CMOS        ARRAY IMAGING.

Applicant of the present application owns the following U.S. patentapplications, filed on Mar. 29, 2018, the disclosure of each of which isherein incorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. 15/940,636, titled ADAPTIVE        CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;    -   U.S. patent application Ser. No. 15/940,653, titled ADAPTIVE        CONTROL PROGRAM UPDATES FOR SURGICAL HUBS;    -   U.S. patent application Ser. No. 15/940,660, titled CLOUD-BASED        MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A        USER;    -   U.S. patent application Ser. No. 15/940,679, titled CLOUD-BASED        MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS WITH THE        RESOURCE ACQUISITION BEHAVIORS OF LARGER DATA SET;    -   U.S. patent application Ser. No. 15/940,694, titled CLOUD-BASED        MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED        INDIVIDUALIZATION OF INSTRUMENT FUNCTION;    -   U.S. patent application Ser. No. 15/940,634, titled CLOUD-BASED        MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND        REACTIVE MEASURES;    -   U.S. patent application Ser. No. 15/940,706, titled DATA        HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK; and    -   U.S. patent application Ser. No. 15/940,675, titled CLOUD        INTERFACE FOR COUPLED SURGICAL DEVICES.

Applicant of the present application owns the following U.S. patentapplications, filed on Mar. 29, 2018, the disclosure of each of which isherein incorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. 15/940,627, titled DRIVE        ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,637, titled        COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS;    -   U.S. patent application Ser. No. 15/940,642, titled CONTROLS FOR        ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,676, titled AUTOMATIC        TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,680, titled CONTROLLERS        FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,683, titled COOPERATIVE        SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,690, titled DISPLAY        ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and    -   U.S. patent application Ser. No. 15/940,711, titled SENSING        ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.

Applicant of the present application owns the following U.S. Provisionalpatent applications, filed on Mar. 28, 2018, the disclosure of each ofwhich is herein incorporated by reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/649,302, titled        INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION        CAPABILITIES;    -   U.S. Provisional Patent Application Ser. No. 62/649,294, titled        DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE        ANONYMIZED RECORD;    -   U.S. Provisional Patent Application Ser. No. 62/649,300, titled        SURGICAL HUB SITUATIONAL AWARENESS;    -   U.S. Provisional Patent Application Ser. No. 62/649,309, titled        SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING        THEATER;    -   U.S. Provisional Patent Application Ser. No. 62/649,310, titled        COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;    -   U.S. Provisional Patent Application Ser. No. 62/649,291, titled        USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE        PROPERTIES OF BACK SCATTERED LIGHT;    -   U.S. Provisional Patent Application Ser. No. 62/649,296, titled        ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;    -   U.S. Provisional Patent Application Ser. No. 62/649,333, titled        CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND        RECOMMENDATIONS TO A USER;    -   U.S. Provisional Patent Application Ser. No. 62/649,327, titled        CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION        TRENDS AND REACTIVE MEASURES;    -   U.S. Provisional Patent Application Ser. No. 62/649,315, titled        DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK;    -   U.S. Provisional Patent Application Ser. No. 62/649,313, titled        CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES;    -   U.S. Provisional Patent Application Ser. No. 62/649,320, titled        DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. Provisional Patent Application Ser. No. 62/649,307, titled        AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS; and    -   U.S. Provisional Patent Application Ser. No. 62/649,323, titled        SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.

Applicant of the present application owns the following U.S. Provisionalpatent application, filed on Apr. 19, 2018, the disclosure of which isherein incorporated by reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/659,900, titled        METHOD OF HUB COMMUNICATION.

Applicant of the present application owns the following U.S. patentapplications, filed on Mar. 29, 2018, the disclosure of each of which isherein incorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. 15/940,641, titled INTERACTIVE        SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES;    -   U.S. patent application Ser. No. 15/940,648, titled INTERACTIVE        SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES AND DATA        CAPABILITIES;    -   U.S. patent application Ser. No. 15/940,656, titled SURGICAL HUB        COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM        DEVICES;    -   U.S. patent application Ser. No. 15/940,666, titled SPATIAL        AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS;    -   U.S. patent application Ser. No. 15/940,670, titled COOPERATIVE        UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES BY        INTELLIGENT SURGICAL HUBS;    -   U.S. patent application Ser. No. 15/940,677, titled SURGICAL HUB        CONTROL ARRANGEMENTS;    -   U.S. patent application Ser. No. 15/940,632, titled DATA        STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE        ANONYMIZED RECORD;    -   U.S. patent application Ser. No. 15/940,640, titled        COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERS AND        STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED        ANALYTICS SYSTEMS;    -   U.S. patent application Ser. No. 15/940,645, titled SELF        DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT;    -   U.S. patent application Ser. No. 15/940,649, titled DATA PAIRING        TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN OUTCOME;    -   U.S. patent application Ser. No. 15/940,654, titled SURGICAL HUB        SITUATIONAL AWARENESS;    -   U.S. patent application Ser. No. 15/940,663, titled SURGICAL        SYSTEM DISTRIBUTED PROCESSING;    -   U.S. patent application Ser. No. 15/940,668, titled AGGREGATION        AND REPORTING OF SURGICAL HUB DATA;    -   U.S. patent application Ser. No. 15/940,671, titled SURGICAL HUB        SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER;    -   U.S. patent application Ser. No. 15/940,686, titled DISPLAY OF        ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE;    -   U.S. patent application Ser. No. 15/940,700, titled STERILE        FIELD INTERACTIVE CONTROL DISPLAYS;    -   U.S. patent application Ser. No. 15/940,629, titled COMPUTER        IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;    -   U.S. patent application Ser. No. 15/940,704, titled USE OF LASER        LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF        BACK SCATTERED LIGHT;    -   U.S. patent application Ser. No. 15/940,722, titled        CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF        MONO-CHROMATIC LIGHT REFRACTIVITY; and    -   U.S. patent application Ser. No. 15/940,742, titled DUAL CMOS        ARRAY IMAGING.

Applicant of the present application owns the following U.S. patentapplications, filed on Mar. 29, 2018, the disclosure of each of which isherein incorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. 15/940,636, titled ADAPTIVE        CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;    -   U.S. patent application Ser. No. 15/940,653, titled ADAPTIVE        CONTROL PROGRAM UPDATES FOR SURGICAL HUBS;    -   U.S. patent application Ser. No. 15/940,660, titled CLOUD-BASED        MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A        USER;    -   U.S. patent application Ser. No. 15/940,679, titled CLOUD-BASED        MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS WITH THE        RESOURCE ACQUISITION BEHAVIORS OF LARGER DATA SET;    -   U.S. patent application Ser. No. 15/940,694, titled CLOUD-BASED        MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED        INDIVIDUALIZATION OF INSTRUMENT FUNCTION;    -   U.S. patent application Ser. No. 15/940,634, titled CLOUD-BASED        MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND        REACTIVE MEASURES;    -   U.S. patent application Ser. No. 15/940,706, titled DATA        HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK; and    -   U.S. patent application Ser. No. 15/940,675, titled CLOUD        INTERFACE FOR COUPLED SURGICAL DEVICES.

Applicant of the present application owns the following U.S. patentapplications, filed on Mar. 29, 2018, the disclosure of each of which isherein incorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. 15/940,627, titled DRIVE        ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,637, titled        COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS;    -   U.S. patent application Ser. No. 15/940,642, titled CONTROLS FOR        ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,676, titled AUTOMATIC        TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,680, titled CONTROLLERS        FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,683, titled COOPERATIVE        SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. patent application Ser. No. 15/940,690, titled DISPLAY        ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and    -   U.S. patent application Ser. No. 15/940,711, titled SENSING        ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.

Applicant of the present application owns the following U.S. Provisionalpatent applications, filed on Mar. 28, 2018, the disclosure of each ofwhich is herein incorporated by reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/649,302, titled        INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION        CAPABILITIES;    -   U.S. Provisional Patent Application Ser. No. 62/649,294, titled        DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE        ANONYMIZED RECORD;    -   U.S. Provisional Patent Application Ser. No. 62/649,300, titled        SURGICAL HUB SITUATIONAL AWARENESS;    -   U.S. Provisional Patent Application Ser. No. 62/649,309, titled        SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING        THEATER;    -   U.S. Provisional Patent Application Ser. No. 62/649,310, titled        COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;    -   U.S. Provisional Patent Application Ser. No. 62/649,291, titled        USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE        PROPERTIES OF BACK SCATTERED LIGHT;    -   U.S. Provisional Patent Application Ser. No. 62/649,296, titled        ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;    -   U.S. Provisional Patent Application Ser. No. 62/649,333, titled        CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND        RECOMMENDATIONS TO A USER;    -   U.S. Provisional Patent Application Ser. No. 62/649,327, titled        CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION        TRENDS AND REACTIVE MEASURES;    -   U.S. Provisional Patent Application Ser. No. 62/649,315, titled        DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK;    -   U.S. Provisional Patent Application Ser. No. 62/649,313, titled        CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES;    -   U.S. Provisional Patent Application Ser. No. 62/649,320, titled        DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;    -   U.S. Provisional Patent Application Ser. No. 62/649,307, titled        AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL        PLATFORMS; and    -   U.S. Provisional Patent Application Ser. No. 62/649,323, titled        SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.

Applicant of the present application owns the following U.S. Provisionalpatent applications, filed on Mar. 8, 2018, the disclosure of each ofwhich is herein incorporated by reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/640,417, titled        TEMPERATURE CONTROL IN ULTRASONIC DEVICE AND CONTROL SYSTEM        THEREFOR; and    -   U.S. Provisional Patent Application Ser. No. 62/640,415, titled        ESTIMATING STATE OF ULTRASONIC END EFFECTOR AND CONTROL SYSTEM        THEREFOR.

Applicant of the present application owns the following U.S. Provisionalpatent applications, filed on Dec. 28, 2017, the disclosure of each ofwhich is herein incorporated by reference in its entirety:

-   -   U.S. Provisional Patent Application Ser. No. 62/611,341, titled        INTERACTIVE SURGICAL PLATFORM;    -   U.S. Provisional Patent Application Ser. No. 62/611,340, titled        CLOUD-BASED MEDICAL ANALYTICS; and    -   U.S. Provisional Patent Application Ser. No. 62/611,339, titled        ROBOT ASSISTED SURGICAL PLATFORM.

Before explaining various aspects of surgical devices and generators indetail, it should be noted that the illustrative examples are notlimited in application or use to the details of construction andarrangement of parts illustrated in the accompanying drawings anddescription. The illustrative examples may be implemented orincorporated in other aspects, variations and modifications, and may bepracticed or carried out in various ways. Further, unless otherwiseindicated, the terms and expressions employed herein have been chosenfor the purpose of describing the illustrative examples for theconvenience of the reader and are not for the purpose of limitationthereof. Also, it will be appreciated that one or more of thefollowing-described aspects, expressions of aspects, and/or examples,can be combined with any one or more of the other following-describedaspects, expressions of aspects and/or examples.

Enemy Devices and Smoke Evacuation

The present disclosure relates to energy devices and intelligentsurgical evacuation systems for evacuating smoke and/or other fluidsand/or particulates from a surgical site. Smoke is often generatedduring a surgical procedure that utilizes one or more energy devices.Energy devices use energy to affect tissue. In an energy device, theenergy is supplied by a generator. Energy devices include devices withtissue-contacting electrodes, such as an electrosurgical device havingone or more radio frequency (RF) electrodes, and devices with vibratingsurfaces, such as an ultrasonic device having an ultrasonic blade. Foran electrosurgical device, a generator is configured to generateoscillating electric currents to energize the electrodes. For anultrasonic device, a generator is configured to generate ultrasonicvibrations to energize the ultrasonic blade. Generators are furtherdescribed herein.

Ultrasonic energy can be utilized for coagulation and cutting tissue.Ultrasonic energy coagulates and cuts tissue by vibrating anenergy-delivery surface (e.g. an ultrasonic blade) in contact withtissue. The ultrasonic blade can be coupled to a waveguide thattransmits the vibrational energy from an ultrasonic transducer, whichgenerates mechanical vibrations and is powered by a generator. Vibratingat high frequencies (e.g., 55,500 times per second), the ultrasonicblade generates friction and heat between the blade and the tissue, i.e.at the blade-tissue interface, which denatures the proteins in thetissue to form a sticky coagulum. Pressure exerted on the tissue by theblade surface collapses blood vessels and allows the coagulum to form ahemostatic seal. The precision of cutting and coagulation can becontrolled by the clinician's technique and by adjusting the powerlevel, blade edge, tissue traction, and blade pressure, for example.

Ultrasonic surgical instruments are finding increasingly widespreadapplications in surgical procedures by virtue of the unique performancecharacteristics of such instruments. Depending upon specific instrumentconfigurations and operational parameters, ultrasonic surgicalinstruments can provide substantially simultaneous cutting of tissue andhemostasis by coagulation, which can desirably minimize patient trauma.The cutting action is typically realized by an end effector, or bladetip, at the distal end of the ultrasonic instrument. The ultrasonic endeffector transmits the ultrasonic energy to tissue brought into contactwith the end effector. Ultrasonic instruments of this nature can beconfigured for open surgical use, laparoscopic surgical procedures, orendoscopic surgical procedures, including robotic-assisted procedures,for example.

Electrical energy can also be utilized for coagulation and/or cutting.An electrosurgical device typically includes a handpiece and aninstrument having a distally-mounted end effector (e.g., one or moreelectrodes). The end effector can be positioned against and/or adjacentto the tissue such that electrical current is introduced into thetissue. Electrosurgery is widely-used and offers many advantagesincluding the use of a single surgical instrument for both coagulationand cutting.

The electrode or tip of the electrosurgical device is small at the pointof contact with the patient to produce an RF current with a high currentdensity in order to produce a surgical effect of coagulating and/orcutting tissue through cauterization. The return electrode carries thesame RF signal back to the electrosurgical generator after it passesthrough the patient, thus providing a return path for the RF signal.

Electrosurgical devices can be configured for bipolar or monopolaroperation. During bipolar operation, current is introduced into andreturned from the tissue by active and return electrodes, respectively,of the end effector. During monopolar operation, current is introducedinto the tissue by an active electrode of the end effector and returnedthrough a return electrode (e.g., a grounding pad) separately located onor against a patient's body. Heat generated by the current flowingthrough the tissue may form hemostatic seals within the tissue and/orbetween tissues and, thus, may be particularly useful for sealing bloodvessels, for example. The end effector of an electrosurgical device alsomay include a cutting member that is movable relative to the tissue andthe electrodes to transect the tissue.

In application, an electrosurgical device can transmit low frequency RFcurrent through tissue, which causes ionic agitation, or friction (ineffect resistive heating), thereby increasing the temperature of thetissue. Because a boundary is created between the affected tissue andthe surrounding tissue, clinicians can operate with a high level ofprecision and control, without sacrificing un-targeted adjacent tissue.The low operating temperature of RF energy is useful for removing,shrinking, or sculpting soft tissue while simultaneously sealing bloodvessels. RF energy can work particularly well on connective tissue,which is primarily comprised of collagen and shrinks when contacted byheat. Other electrosurgical instruments include, without limitation,irreversible and/or reversible electroporation, and/or microwavetechnologies, among others. The techniques disclosed herein areapplicable to ultrasonic, bipolar and/or monopolar RF (electrosurgical),irreversible and/or reversible electroporation, and/or microwave basedsurgical instruments, among others.

Electrical energy applied by an electrosurgical device can betransmitted to the instrument from a generator. The generator isconfigured to convert electricity to high frequency waveforms comprisedof oscillating electric currents, which are transmitted to theelectrodes to affect tissue. The current passes through tissue tofulgurate (a form of coagulation in which a current arc over the tissuecreates tissue charring), desiccate (a direct energy application thatdrives water of the cells), and/or cut (an indirect energy applicationthat vaporizes cellular fluid causing cellular explosions) tissue. Thetissue's response to the current is a function of the resistance of thetissue, the current density passing through the tissue, the poweroutput, and the duration of current application. In certain instances,as further described herein, the current waveform can be adjusted toaffect a different surgical function and/or accommodate tissue ofdifferent properties. For example, different types of tissue—vasculartissue, nerve tissue, muscles, skin, fat and/or bone—can responddifferently to the same waveform.

The electrical energy may be in the form of RF energy that may be in afrequency range described in EN 60601-2-2:2009+A11:2011, Definition201.3.218—HIGH FREQUENCY. For example, the frequencies in monopolar RFapplications are typically restricted to less than 5 MHz to minimize theproblems associated with high frequency leakage current. Frequenciesabove 200 kHz can be typically used for monopolar applications in orderto avoid the unwanted stimulation of nerves and muscles that wouldresult from the use of low frequency current.

In bipolar RF applications, the frequency can be almost anything. Lowerfrequencies may be used for bipolar techniques in certain instances,such as if a risk analysis shows that the possibility of neuromuscularstimulation has been mitigated to an acceptable level. It is generallyrecognized that 10 mA is the lower threshold of thermal effects ontissue. Higher frequencies may also be used in the case of bipolartechniques.

In certain instances, a generator can be configured to generate anoutput waveform digitally and provide it to a surgical device such thatthe surgical device may utilize the waveform for various tissue effects.The generator can be a monopolar generator, a bipolar generator, and/oran ultrasonic generator. For example, a single generator can supplyenergy to a monopolar device, a bipolar device, an ultrasonic device, ora combination electrosurgery/ultrasonic device. The generator canpromote tissue-specific effects via wave-shaping, and/or can drive RFand ultrasonic energy simultaneously and/or sequentially to a singlesurgical instrument or multiple surgical instruments.

In one instance, a surgical system can include a generator and varioussurgical instruments usable therewith, including an ultrasonic surgicalinstrument, an RF electrosurgical instrument, and a combinationultrasonic/RF electrosurgical instrument. The generator can beconfigurable for use with the various surgical instruments as furtherdescribed in U.S. patent application Ser. No. 15/265,279, titledTECHNIQUES FOR OPERATING GENERATOR FOR DIGITALLY GENERATING ELECTRICALSIGNAL WAVEFORMS AND SURGICAL INSTRUMENTS, filed Sep. 14, 2016, now U.S.Patent Application Publication No. 2017/0086914, which is hereinincorporated by reference in its entirety.

As described herein, medical procedures of cutting tissue and/orcauterizing blood vessels are often performed by utilizing RF electricalenergy, which is produced by a generator and transmitted to a patient'stissue through an electrode that is operated by a clinician. Theelectrode delivers an electrical discharge to cellular matter of thepatient's body adjacent to the electrode. The discharge causes thecellular matter to heat up in order to cut tissue and/or cauterize bloodvessels.

The high temperatures involved in electrosurgery can cause thermalnecrosis of the tissue adjacent to the electrode. The longer time atwhich tissue is exposed to the high temperatures involved withelectrosurgery, the more likely it is that the tissue will sufferthermal necrosis. In certain instances, thermal necrosis of the tissuecan decrease the speed of cutting the tissue and increase post-operativecomplications, eschar production, and healing time, as well asincreasing incidences of heat damage to the tissue positioned away fromthe cutting site.

The concentration of the RF energy discharge affects both the efficiencywith which the electrode is able to cut tissue and the likelihood oftissue damage away from the cutting site. With a standard electrodegeometry, the RF energy tends to be uniformly distributed over arelatively large area adjacent to the intended incision site. Agenerally uniform distribution of the RF energy discharge increases thelikelihood of extraneous charge loss into the surrounding tissue, whichmay increase the likelihood of unwanted tissue damage in the surroundingtissue.

Typical electrosurgical generators generate various operatingfrequencies of RF electrical energy and output power levels. Thespecific operating frequency and power output of a generator variesbased upon the particular electrosurgical generator used and the needsof the physician during the electrosurgical procedure. The specificoperating frequency and power output levels can be manually adjusted onthe generator by a clinician or other operating room personnel. Properlyadjusting these various settings requires great knowledge, skill, andattention from the clinician or other personnel. Once the clinician hasmade the desired adjustments to the various settings on the generator,the generator can maintain those output parameters duringelectrosurgery. Generally, wave generators used for electrosurgery areadapted to produce RF waves with an output power in the range of 1-300Win a cut mode and 1-120 W in coagulation mode, and a frequency in therange of 300-600 kHz. Typical wave generators are adapted to maintainthe selected settings during the electrosurgery. For example, if theclinician were to set the output power level of the generator to 50 Wand then touch the electrode to the patient to perform electrosurgery,the power level of the generator would quickly rise to and be maintainedat 50 W. While setting the power level to a specific setting, such as 50W, will allow the clinician to cut through the patient's tissue,maintaining such a high power level increases the likelihood of thermalnecrosis of the patient's tissue.

In some forms, a generator is configured to provide sufficient power toeffectively perform electrosurgery in connection with an electrode thatincreases the concentration of the RF energy discharge, while at thesame time limiting unwanted tissue damage, reducing post-operativecomplications, and facilitating quicker healing. For example, thewaveform from the generator can be optimized by a control circuitthroughout the surgical procedure. The subject matter claimed herein,however, is not limited to aspects that solve any disadvantages or thatoperate only in environments such as those described above. Rather, thisbackground is only provided to illustrate one example of a technologyarea where some aspects described herein may be practiced.

As provided herein, energy devices delivery mechanical and/or electricalenergy to target tissue in order to treat the tissue (e.g. to cut thetissue, cauterize blood vessels and/or coagulate the tissue withinand/or near the targeted tissue). The cutting, cauterization, and/orcoagulation of tissue can result in fluids and/or particulates beingreleased into the air. Such fluids and/or particulates emitted during asurgical procedure can constitute smoke, for example, which can comprisecarbon particles and/or other particles suspended in air. In otherwords, a fluid can comprise smoke and/or other fluidic matter.Approximately 90% of endoscopic and open surgical procedures generatesome level of smoke. The smoke can be unpleasant to the olfactory sensesof the clinician(s), the assistant(s), and/or the patient(s), mayobstruct the clinician(s)'s view of the surgical site, and may beunhealthy to inhale in certain instances. For example, smoke generatedduring an electrosurgical procedure can contain toxic chemicalsincluding acrolein, acetonitrile, acrylonitrile, acetylene, alkylbenzenes, benzene, butadiene, butene, carbon monoxide, creosols, ethane,ethylene, formaldehyde, free radicals, hydrogen cyanide, isobutene,methane, phenol, polycyclic aromatic hydrocarbons, propene, propylene,pyridene, pyrrole, styrene, toluene, and xylene, as well as dead andlive cellular material (including blood fragments), and viruses. Certainmaterial that has been identified in surgical smoke has been identifiedas known carcinogens. It is estimated that one gram of tissue cauterizedduring an electrosurgical procedure can be equivalent to the toxins andcarcinogens of six unfiltered cigarettes. Additionally, exposure to thesmoke released during an electrosurgical procedure has been reported tocause eye and lung irritation to health care workers.

In addition to the toxicity and odors associated with the material insurgical smoke, the size of particulate matter in surgical smoke can beharmful to the respiratory system of the clinician(s), the assistant(s),and/or the patient(s). In certain instances, the particulates can beextremely small. Repeated inhalation of extremely small particulatematter can lead to acute and chronic respiratory conditions in certaininstances.

Many electrosurgical systems employ a surgical evacuation system thatcaptures the resultant smoke from a surgical procedure, and directs thecaptured smoke through a filter and an exhaust port away from theclinician(s) and/or from the patient(s). For example, an evacuationsystem can be configured to evacuate smoke that is generated during anelectrosurgical procedure. The reader will appreciate that such anevacuation system can be referred to as a “smoke evacuation system”though such evacuation systems can be configured to evacuate more thanjust smoke from a surgical site. Throughout the present disclosure, the“smoke” evacuated by an evacuation system is not limited to just smoke.Rather, the smoke evacuation systems disclosed herein can be used toevacuate a variety of fluids, including liquids, gases, vapors, smoke,steam, or combinations thereon. The fluids can be biologic in originand/or can be introduced to the surgical site from an external sourceduring a procedure. The fluids can include water, saline, lymph, blood,exudate, and/or pyogenic discharge, for example. Moreover, the fluidscan include particulates or other matter (e.g. cellular matter ordebris) that is evacuated by the evacuation system. For example, suchparticulates can be suspended in the fluid.

Evacuation systems often include a pump and a filter. The pump createssuction that draws the smoke into the filter. For example, suction canbe configured to draw smoke from the surgical site into a conduitopening, through an evacuation conduit, and into an evacuator housing ofthe evacuation system. An evacuator housing 50018 for a surgicalevacuation system 50000 is shown in FIG. 1. In one aspect of the presentdisclosure, a pump and a filter are positioned within the evacuatorhousing 50018. Smoke drawn into the evacuator housing 50018 travels tothe filter via a suction conduit 50036, and harmful toxins and offensivesmells are filtered out of the smoke as it moves through the filter. Thesuction conduit can also be referred to as vacuum and/or evacuationconduit and/or tube, for example. Filtered air may then exit thesurgical evacuation system as exhaust. In certain instances, variousevacuation systems disclosed herein can also be configured to deliverfluids to a desired location, such as a surgical site.

Referring now to FIG. 2, the suction conduit 50036 from the evacuatorhousing 50018 (FIG. 1) may terminate at a hand piece, such as thehandpiece 50032. The handpiece 50032 comprises an electrosurgicalinstrument that includes an electrode tip 50034 and an evacuationconduit opening near and/or adjacent to the electrode tip 50034. Theevacuation conduit opening is configured to capture the fluid and/orparticulates that are released during a surgical procedure. In such aninstance, the evacuation system 50000 is integrated into theelectrosurgical instrument 50032. Referring still to FIG. 2, smoke S isbeing pulled into the suction conduit 50036.

In certain instances, the evacuation system 50000 can include a separatesurgical tool that comprises a conduit opening and is configured to suckthe smoke out into the system. In still other instances, a toolcomprising the evacuation conduit and opening can be snap fit onto anelectrosurgical tool as depicted in FIG. 3. For example, a portion of asuction conduit 51036 can be positioned around (or adjacent to) anelectrode tip 51034. In one instance, the suction conduit 51036 can bereleasably secured to a handpiece 51032 of an electrosurgical toolcomprising the electrode tip 51034 with clips or other fasteners.

Various internal components of an evacuator housing 50518 are shown inFIG. 4. In various instances, the internal components in FIG. 4 can alsobe incorporated into the evacuator housing 50018 of FIG. 1. Referringprimarily to FIG. 4, an evacuation system 50500 includes the evacuatorhousing 50518, a filter 50502, an exhaust mechanism 50520, and a pump50506. The evacuation system 50500 defines a flow path 50504 through theevacuator housing 50518 having an inlet port 50522 and an outlet port50524. The filter 50502, the exhaust mechanism 50520, and the pump 50506are sequentially arranged in-line with the flow path 50504 through theevacuator housing 50518 between the inlet port 50522 and the outlet port50524. The inlet port 50522 can be fluidically coupled to a suctionconduit, such as the suction conduit 50036 in FIG. 1, for example, whichcan comprise a distal conduit opening positionable at the surgical site.

The pump 50506 is configured to produce a pressure differential in theflow path 50504 by a mechanical action. The pressure differential isconfigured to draw smoke 50508 from the surgical site into the inletport 50522 and along the flow path 50504. After the smoke 50508 hasmoved through the filter 50502, the smoke 50508 can be considered to befiltered smoke, or air, 50510, which can continue through the flow path50504 and is expelled through the outlet port 50524. The flow path 50504includes a first zone 50514 and a second zone 50516. The first zone50514 is upstream from the pump 50506; the second zone 50516 isdownstream from the pump 50506. The pump 50506 is configured topressurize the fluid in the flow path 50504 so that the fluid in thesecond zone 50516 has a higher pressure than the fluid in the first zone50514. A motor 50512 drives the pump 50506. Various suitable motors arefurther described herein. The exhaust mechanism 50520 is a mechanismthat can control the velocity, the direction, and/or other properties ofthe filtered smoke 50510 exiting the evacuation system 50500 at theoutlet port 50524.

The flow path 50504 through the evacuation system 50500 can be comprisedof a tube or other conduit that substantially contains and/or isolatesthe fluid moving through the flow path 50504 from the fluid outside theflow path 50504. For example, the first zone 50514 of the flow path50504 can comprise a tube through which the flow path 50504 extendsbetween the filter 50502 and the pump 50506. The second zone 50516 ofthe flow path 50504 can also comprise a tube through which the flow path50504 extends between the pump 50506 and the exhaust mechanism 50520.The flow path 50504 also extends through the filter 50502, the pump50506, and the exhaust mechanism 50520 so that the flow path 50504extends continuously from the inlet port 50522 to the outlet port 50524.

In operation, the smoke 50508 can flow into the filter 50502 at theinlet port 50522 and can be pumped through the flow path 50504 by thepump 50506 such that the smoke 50508 is drawn into the filter 50502. Thefiltered smoke 50510 can then be pumped through the exhaust mechanism50520 and out the outlet port 50524 of the evacuation system 50500. Thefiltered smoke 50510 exiting the evacuation system 50500 at the outletport 50524 is the exhaust, and can consist of filtered gases that havepassed through the evacuation system 50500.

In various instances, the evacuation systems disclosed herein (e.g. theevacuation system 50000 and the evacuation system 50500) can beincorporated into a computer-implemented interactive surgical system,such as the system 100 (FIG. 39) or the system 200 (FIG. 47), forexample. In one aspect of the present disclosure, for example, thecomputer-implemented surgical system 100 can include at least one hub106 and a cloud 104. Referring primarily to FIG. 41, the hub 106includes a smoke evacuation module 126. Operation of the smokeevacuation module 126 can be controlled by the hub 106 based on itssituational awareness and/or feedback from the components thereof and/orbased on information from the cloud 104. The computer-implementedsurgical systems 100 and 200, as well as situational awareness therefor,are further described herein.

Situational awareness encompasses the ability of some aspects of asurgical system to determine or infer information related to a surgicalprocedure from data received from databases and/or instruments. Theinformation can include the type of procedure being undertaken, the typeof tissue being operated on, or the body cavity that is the subject ofthe procedure. With the contextual information related to the surgicalprocedure, the surgical system can, for example, improve the manner inwhich it controls the modular devices (e.g. a smoke evacuation system)that are connected to it and provide contextualized information orsuggestions to the clinician during the course of the surgicalprocedure. Situational awareness is further described herein and in U.S.Provisional Patent Application Ser. No. 62/611,341, entitled INTERACTIVESURGICAL PLATFORM, filed Dec. 28, 2017, which is incorporated byreference herein in its entirety.

In various instances, the surgical systems and/or evacuation systemsdisclosed herein can include a processor. The processor can beprogrammed to control one or more operational parameters of the surgicalsystem and/or the evacuation system based on sensed and/or aggregateddata and/or one or more user inputs, for example. FIG. 5 is a schematicrepresentation of an electrosurgical system 50300 including a processor50308. The electrosurgical system 50300 is powered by an AC source50302, which provides either 120 V or 240 V alternating current. Thevoltage supplied by the AC source 50302 is directed to an AC/DCconverter 50304, which converts the 120 V or 240 V of alternatingcurrent to 360 V of direct current. The 360 V of direct current is thendirected to a power converter 50306 (e.g., a buck converter). The powerconverter 50306 is a step-down DC to DC converter. The power converter50306 is adapted to step-down the incoming 360 V to a desired levelwithin a range between 0-150 V.

The processor 50308 can be programmed to regulate various aspects,functions, and parameters of the electrosurgical system 50300. Forinstance, the processor 50308 can determine the desired output powerlevel at an electrode tip 50334, which can be similar in many respectsto the electrode tip 50034 in FIG. 2 and/or the electrode tip 51034 inFIG. 3, for example, and direct the power converter 50306 to step-downthe voltage to a specified level so as to provide the desired outputpower. The processor 50308 is coupled to a memory 50310 configured tostore machine executable instructions to operate the electrosurgicalsystem 50300 and/or subsystems thereof.

Connected between the processor 50308 and the power converter 50306 is adigital-to-analog converter (“DAC”) 50312. The DAC 50312 is adapted toconvert a digital code created by the processor 50308 to an analogsignal (current, voltage, or electric charge) which governs the voltagestep-down performed by the power converter 50306. Once the powerconverter 50306 steps-down the 360 V to a level that the processor 50308has determined will provide the desired output power level, thestepped-down voltage is directed to the electrode tip 50334 toeffectuate electrosurgical treatment of a patient's tissue and is thendirected to a return or ground electrode 50335. A voltage sensor 50314and a current sensor 50316 are adapted to detect the voltage and currentpresent in the electrosurgical circuit and communicate the detectedparameters to the processor 50308 so that the processor 50308 candetermine whether to adjust the output power level. As noted herein,typical wave generators are adapted to maintain the selected settingsthroughout an electrosurgical procedure. In other instances, theoperational parameters of a generator can be optimized during a surgicalprocedure based on one or more inputs to the processor 5308, such asinputs from a surgical hub, cloud, and/or situational awareness module,for example, as further described herein.

The processor 50308 is coupled to a communication device 50318 tocommunicate over a network. The communication device includes atransceiver 50320 configured to communicate over physical wires orwirelessly. The communication device 50318 may further include one ormore additional transceivers. The transceivers may include, but are notlimited to cellular modems, wireless mesh network transceivers, Wi-Fi®transceivers, low power wide area (LPWA) transceivers, and/or near fieldcommunications transceivers (NFC). The communication device 50318 mayinclude or may be configured to communicate with a mobile telephone, asensor system (e.g., environmental, position, motion, etc.) and/or asensor network (wired and/or wireless), a computing system (e.g., aserver, a workstation computer, a desktop computer, a laptop computer, atablet computer (e.g., iPad®, GalaxyTab® and the like), an ultraportablecomputer, an ultramobile computer, a netbook computer and/or asubnotebook computer; etc. In at least one aspect of the presentdisclosure, one of the devices may be a coordinator node.

The transceivers 50320 may be configured to receive serial transmit datavia respective UARTs from the processor 50308, to modulate the serialtransmit data onto an RF carrier to produce a transmit RF signal and totransmit the transmit RF signal via respective antennas. Thetransceiver(s) are further configured to receive a receive RF signal viarespective antennas that includes an RF carrier modulated with serialreceive data, to demodulate the receive RF signal to extract the serialreceive data and to provide the serial receive data to respective UARTsfor provision to the processor. Each RF signal has an associated carrierfrequency and an associated channel bandwidth. The channel bandwidth isassociated with the carrier frequency, the transmit data and/or thereceive data. Each RF carrier frequency and channel bandwidth arerelated to the operating frequency range(s) of the transceiver(s) 50320.Each channel bandwidth is further related to the wireless communicationstandard and/or protocol with which the transceiver(s) 50320 may comply.In other words, each transceiver 50320 may correspond to animplementation of a selected wireless communication standard and/orprotocol, e.g., IEEE 802.11 a/b/g/n for Wi-Fi® and/or IEEE 802.15.4 forwireless mesh networks using Zigbee routing.

The processor 50308 is coupled to a sensing and intelligent controlsdevice 50324 that is coupled to a smoke evacuator 50326. The smokeevacuator 50326 can include one or more sensors 50327, and can alsoinclude a pump and a pump motor controlled by a motor driver 50328. Themotor driver 50328 is communicatively coupled to the processor 50308 anda pump motor in the smoke evacuator 50326. The sensing and intelligentcontrols device 50324 includes sensor algorithms 50321 and communicationalgorithms 50322 that facilitate communication between the smokeevacuator 50326 and other devices to adapt their control programs. Thesensing and intelligent controls device 50324 is configured to evaluateextracted fluids, particulates, and gases via an evacuation conduit50336 to improve smoke extraction efficiency and/or reduce device smokeoutput, for example, as further described herein. In certain instances,the sensing and intelligent controls device 50324 is communicativelycoupled to one or more sensors 50327 in the smoke evacuator 50326, oneor more internal sensors 50330 and/or one or more external sensors 50332of the electrosurgical system 50300.

In certain instances, a processor can be located within an evacuatorhousing of a surgical evacuation system. For example, referring to FIG.6, a processor 50408 and a memory 50410 therefor are positioned withinan evacuator housing 50440 of a surgical evacuation system 50400. Theprocessor 50408 is in signal communication with a motor driver 50428,various internal sensors 50430, a display 50442, the memory 50410, and acommunication device 50418. The communication device 50418 is similar inmany respects to the communication device 50318 described above withrespect to FIG. 5. The communication device 50418 can allow theprocessor 50408 in the surgical evacuation system 50400 to communicatewith other devices within a surgical system. For example, thecommunication device 50418 can allow wired and/or wireless communicationto one or more external sensors 50432, one or more surgical devices50444, one or more hubs 50448, one or more clouds 50446, and/or one ormore additional surgical systems and/or tools. The reader will readilyappreciate that the surgical evacuation system 50400 of FIG. 6 can beincorporated into the electrosurgical system 50300 of FIG. 5 in certaininstances. The surgical evacuation system 50400 also includes a pump50450, including a pump motor 50451 thereof, an evacuation conduit50436, and an exhaust 50452. Various pumps, evacuation conduits andexhausts are further described herein. The surgical evacuation system50400 can also include a sensing and intelligent controls device, whichcan be similar in many respects to the sensing and intelligent controlsdevice 50324, for example. For example, such a sensing and intelligentcontrols device can be in signal communication with the processor 50408and/or one or more of the sensors 50430 and/or external sensors 50432.

The electrosurgical system 50300 (FIG. 5) and/or the surgical evacuationsystem 50400 (FIG. 6) can be programmed to monitor one or moreparameters of a surgical system and can affect a surgical function basedon one or more algorithms stored in a memory in signal communicationwith the processor 50308 and/or 50408. Various exemplary aspectsdisclosed herein can be implemented by such algorithms, for example.

In one aspect of the present disclosure, a processor and sensor system,such as the processors 50308 and 50408 and respective sensor systems incommunication therewith (FIGS. 5 and 6), are configured to sense theairflow through a vacuum source in order to adjust parameters of thesmoke evacuation system and/or external devices and/or systems that areused in tandem with the smoke evacuation system, such as anelectrosurgical system, energy device, and/or generator, for example. Inone aspect of the present disclosure, the sensor system may includemultiple sensors positioned along the airflow path of the surgicalevacuation system. The sensors can measure a pressure differentialwithin the evacuation system, in order to detect a state or status ofthe system between the sensors. For example, the system between twosensors can be a filter, and the pressure differential can be used toincrease the speed of the pump motor as flow through the filter isreduced, in order to maintain a flow rate through the system. As anotherexample, the system can be a fluid trap of the evacuation system, andthe pressure differential can be used to determine an airflow paththrough the evacuation system. In still another example, the system canbe the inlet and outlet (or exhaust) of the evacuation system, and thepressure differential can be used to determine the maximum suction loadin the evacuation system in order to maintain the maximum suction loadbelow a threshold value.

In one aspect of the present disclosure, a processor and sensor system,such as the processors 50308 and 50408 and respective sensor systems incommunication therewith (FIGS. 5 and 6), are configured to detect theratio of an aerosol or carbonized particulate, i.e. smoke, in the fluidextracted from a surgical site. For example, the sensing system mayinclude a sensor that detects the size and/or the composition ofparticles, which is used to select an airflow path through theevacuation system. In such instances, the evacuation system can includea first filtering path, or first filtering state, and a second filteringpath, or second filtering state, which can have different properties. Inone instance, the first path includes only a particulate filter, and thesecond path includes both a fluid filter and the particulate filter. Incertain instances, the first path includes a particulate filter, and thesecond path includes the particulate filter and a finer particulatefilter arranged in series. Additional and/or alternative filtering pathsare also envisioned.

In one aspect of the present disclosure, a processor and sensor system,such as the processors 50308 and 50408 and respective sensor systems incommunication therewith (FIGS. 5 and 6), are configured to perform achemical analysis on the particles evacuated from within the abdomencavity of a patient. For example, the sensing and intelligent controlsdevice 50324 may sense the particle count and type in order to adjustthe power level of the ultrasonic generator in order to induce theultrasonic blade to produce less smoke. In another example, the sensorsystems may include sensors for detecting the particle count, thetemperature, the fluid content, and/or the contamination percentage ofthe evacuated fluid, and can communicate the detected property orproperties to a generator in order to adjust its output. For example,the smoke evacuator 50326 and/or the sensing and intelligent controlsdevice 50324 therefor can be configured to adjust the evacuation flowrate and/or the pump's motor speed and, at a predefined particulatelevel, may operably affect the output power or waveform of the generatorto lower the smoke generated by the end effector.

In one aspect of the present disclosure, a processor and sensor system,such as the processors 50308 and 50408 and respective sensor systemstherewith (FIGS. 5 and 6), are configured to evaluate particle count andcontamination in the operating room by evaluating one or more propertiesin the ambient air and/or the exhaust from the evacuator housing. Theparticle count and/or the air quality can be displayed on the smokeevacuation system, such as on the evacuator housing, for example, inorder to communicate the information to a clinician and/or to establishthe effectiveness of the smoke evacuation system and filter(s) thereof.

In one aspect of the present disclosure, a processor, such as theprocessor 50308 or the processor 50408 (FIGS. 5 and 6), for example, isconfigured to compare a sample rate image obtained from an endoscope tothe evacuator particle count from the sensing system (e.g. the sensingand intelligent controls device 50324) in order to determine acorrelation and/or to adjust the rate of the pump'srevolutions-per-minute (RPM). In one instance, the activation of thegenerator can be communicated to the smoke evacuator such that ananticipated, required rate of smoke evacuation can be implemented. Thegenerator activation can be communicated to the surgical evacuationsystem through a surgical hub, cloud communication system, and/or directconnection, for example.

In one aspect of the present disclosure, sensor systems and algorithmsfor a smoke evacuation system (see, e.g. FIGS. 5 and 6) can beconfigured to control the smoke evacuator, and can adapt motorparameters thereof to adjust the filtering efficiency of the smokeevacuator based on the needs of the surgical field at a given time. Inone instance, an adaptive airflow pump speed algorithm is provided toautomatically change the motor pump speed based on the sensedparticulate into the inlet of the smoke evacuator and/or out of theoutlet or exhaust of the smoke evacuator. For example, the sensing andintelligent controls device 50324 (FIG. 5) can include a user-selectablespeed and an auto-mode speed, for example. In the auto-mode speed, theairflow through the evacuation system can be scalable based on the smokeinto the evacuation system and/or a lack of filtered particles out ofthe smoke evacuation system. The auto-mode speed can provide automaticsensing and compensation for laparoscopic mode in certain instances.

In one aspect of the present disclosure, the evacuation system caninclude an electrical and communication architecture (see, e.g. FIGS. 5and 6) that provides data collection and communication features, inorder to improve interactivity with a surgical hub and a cloud. In oneexample, a surgical evacuation system and/or processor therefor, such asthe processor 50308 (FIG. 5) and the processor 50408 (FIG. 6), forexample, can include a segmented control circuit that is energized in astaged method to check for errors, shorts, and/or safety checks of thesystem. The segmented control circuit may also be configured to have aportion energized and a portion not energized until the energizedportion performs a first function. The segmented control circuit caninclude circuit elements to identify and display status updates to theuser of attached components. The segmented control circuit also includescircuit elements for running the motor in a first state, in which themotor is activated by the user, and in a second state, in which themotor has not been activated by the user but runs the pump in a quietermanner and at a slower rate. A segmented control circuit can allow thesmoke evacuator to be energized in stages, for example.

The electrical and communication architecture for the evacuation system(see, e.g. FIGS. 5 and 6) can also provide interconnectivity of thesmoke evacuator with other components within the surgical hub forinteractions, as well as communication of data with a cloud.Communication of surgical evacuation system parameters to a surgical huband/or cloud can be provided to affect the output or operation of otherattached devices. The parameters can be operational or sensed.Operational parameters include airflow, pressure differentials, and airquality. Sensed parameters include particulate concentration, aerosolpercentage, and chemical analysis.

In one aspect of the present disclosure, the evacuation system, such asthe surgical evacuation system 50400, for example, can also include anenclosure and replaceable components, controls, and a display. Circuitelements are provided for communicating the security identification (ID)between such replaceable components. For example, communication betweena filter and the smoke evacuation electronics can be provided to verifyauthenticity, remaining life of the component, to update parameters inthe component, to log errors, and/or to limit the number and/or the typeof components that can be identified by the system. In variousinstances, the communication circuit can authenticate features forenabling and/or disabling of configuration parameters. The communicationcircuit can employ encryption and/or error handling schemes to managesecurity and proprietary relationships between the component and thesmoke evacuation electronics. Disposable/re-useable components areincluded in certain instances.

In one aspect of the present disclosure, the evacuation systems canprovide fluid management and extraction filters and airflowconfigurations. For example, a surgical evacuation system including afluid capture mechanism is provided where the fluid capture mechanismhas a first and a second set of extraction or airflow control features,which are in series with each other to extract large and small fluiddroplets, respectively. In certain instances, the airflow path cancontain a recirculation channel or secondary fluid channel back to theprimary reservoir from downstream of the exhaust port of the main fluidmanagement chamber.

In one aspect of the present disclosure, an advanced pad can be coupledto the electrosurgical system. For example, the ground electrode 50335of the electrosurgical system 50300 (FIG. 5) can include an advanced padhaving localized sensing that is integrated into the pad whilemaintaining the capacitive coupling. For example, the capacitivecoupling return path pad can have small separable array elements, whichcan be used to sense nerve control signals and/or movement of selectanatomic locations, in order to detect the proximity of the monopolartip to a nerve bundle.

An electrosurgical system can includes a signal generator, anelectrosurgical instrument, a return electrode, and a surgicalevacuation system. The generator may be an RF wave generator thatproduces RF electrical energy. Connected to the electrosurgicalinstrument is a utility conduit. The utility conduit includes a cablethat communicates electrical energy from the signal generator to theelectrosurgical instrument. The utility conduit also includes a vacuumhose that conveys captured/collected smoke and/or fluid away from asurgical site. Such an exemplary electrosurgical system 50601 is shownin FIG. 7. More specifically, the electrosurgical system 50601 includesa generator 50640, an electrosurgical instrument 50630, a returnelectrode 50646, and an evacuation system 50600. The electrosurgicalinstrument 50630 includes a handle 50632 and a distal conduit opening50634 that is fluidically coupled to a suction hose 50636 of theevacuation system 50600. The electrosurgical instrument 50630 alsoincludes an electrode that is powered by the generator 50640. A firstelectrical connection 50642, e.g., a wire, extends from theelectrosurgical instrument 50630 to the generator 50640. A secondelectrical connection 50644, e.g., a wire, extends from theelectrosurgical instrument 50630 to electrode, i.e., the returnelectrode 50646. In other instances, the electrosurgical instrument50630 can be a bipolar electrosurgical instrument. The distal conduitopening 50634 on the electrosurgical instrument 50630 is fluidicallycoupled to the suction hose 50636 that extends to a filter end cap 50603of a filter that is installed in an evacuator housing 50618 of theevacuation system 50600.

In other instances, the distal conduit opening 50634 for the evacuationsystem 50600 can be on a handpiece or tool that is separate from theelectrosurgical instrument 50630. For example, the evacuation system50600 can include a surgical tool that is not coupled to the generator50640 and/or does not include tissue-energizing surfaces. In certaininstances, the distal conduit opening 50634 for the evacuation system50600 can be releasably attached to an electrosurgical tool. Forexample, the evacuation system 50600 can include a clip-on or snap-onconduit terminating at a distal conduit opening, which can be releasablyattached to a surgical tool (see, e.g., FIG. 3).

The electrosurgical instrument 50630 is configured to deliver electricalenergy to target tissue of a patient to cut the tissue and/or cauterizeblood vessels within and/or near the target tissue, as described herein.Specifically, an electrical discharge is provided by the electrode tipto the patient in order to cause heating of cellular matter of thepatient that is in close contact with or adjacent to electrode tip. Thetissue heating takes place at an appropriately high temperature to allowthe electrosurgical instrument 50630 to be used to performelectrosurgery. The return electrode 50646 is either applied to orplaced in close proximity to the patient (depending on the type ofreturn electrode), in order to complete the circuit and provide a returnelectrical path to the generator 50640 for energy that passes into thepatient's body.

The heating of cellular matter of the patient by the electrode tip, orcauterization of blood vessels to prevent bleeding, often results insmoke being released where the cauterization takes place, as furtherdescribed herein. In such instances, because the evacuation conduitopening 50634 is near the electrode tip, the evacuation system 50600 isconfigured to capture the smoke that is released during a surgicalprocedure. Vacuum suction may draw the smoke into the conduit opening50634, through the electrosurgical instrument 50630, and into thesuction hose 50636 toward the evacuator housing 50618 of the evacuationsystem 50600.

Referring now to FIG. 8, the evacuator housing 50618 of the evacuationsystem 50600 (FIG. 7) is depicted. The evacuator housing 50618 includesa socket 50620 that is dimensioned and structured to receive a filter.The evacuator housing 50618 can completely or partially encompass theinternal components of the evacuator housing 50618. The socket 50620includes a first receptacle 50622 and a second receptacle 50624. Atransition surface 50626 extends between the first receptacle 50622 andthe second receptacle 50624.

Referring primarily now to FIG. 9, the socket 50620 is depicted along across sectional plane indicated in FIG. 8. The socket 50620 includes afirst end 50621 that is open to receive a filter and a second end 50623in communication with a flow path 50699 through the evacuator housing50618. A filter 50670 (FIGS. 10 and 11) may be removably positioned withthe socket 50620. For example, the filter 50670 can be inserted andremoved from the first end 50621 of the socket 50620. The secondreceptacle 50624 is configured to receive a connection nipple of thefilter 50670.

Surgical evacuation systems often use filters to remove unwantedpollutants from the smoke before the smoke is released as exhaust. Incertain instances, the filters can be replaceable. The reader willappreciate that the filter 50670 depicted in FIGS. 10 and 11 can beemployed in various evacuation systems disclosed herein. The filter50670 can be a replaceable and/or disposable filter.

The filter 50670 includes a front cap 50672, a back cap 50674, and afilter body 50676 disposed therebetween. The front cap 50672 includes afilter inlet 50678, which, in certain instances, is configured toreceive smoke directly from the suction hose 50636 (FIG. 7) or othersmoke source. In some aspects of the present disclosure, the front cap50672 can be replaced by a fluid trap (e.g. the fluid trap 50760depicted in FIGS. 14-17) that directs the smoke directly from the smokesource, and after removing at least a portion of the fluid therefrom,passes the partially processed smoke into the filter body 50676 forfurther processing. For example, the filter inlet 50678 can beconfigured to receive smoke via a fluid trap exhaust port, such as aport 50766 in a fluid trap 50760 (FIGS. 14-17) to communicate partiallyprocessed smoke into the filter 50670.

Once the smoke enters the filter 50670, the smoke can be filtered bycomponents housed within the filter body 50676. The filtered smoke canthen exit the filter 50670 through a filter exhaust 50680 defined in theback cap 50674 of the filter 50670. When the filter 50670 is associatedwith an evacuation system, suction generated in the evacuator housing50618 of the evacuation system 50600 can be communicated to the filter50670 through the filter exhaust 50680 to pull the smoke through theinternal filtering components of the filter 50670. A filter oftenincludes a particulate filter and a charcoal filter. The particulatefilter can be a high-efficiency particulate air (HEPA) filter or anultra-low penetration air (ULPA) filter, for example. ULPA filtrationutilizes a depth filter that is similar to a maze. The particulate canbe filtered using at least one of the following methods: directinterception (in which particles over 1.0 micron are captured becausethey are too large to pass through the fibers of the media filter),inertial impaction (in which particles between 0.5 and 1.0 microncollide with the fibers and remain there, and diffusional interception(in which particles less than 0.5 micron are captured by the effect ofBrownian random thermal motion as the particles “search out” fibers andadhere to them).

The charcoal filter is configured to remove toxic gases and/or odorgenerated by the surgical smoke. In various instances, the charcoal canbe “activated” meaning it has been treated with a heating process toexpose the active absorption sites. The charcoal can be from activatedvirgin coconut shells, for example.

Referring now to FIG. 11, the filter 50670 includes a coarse mediafilter layer 50684 followed by a fine particulate filter layer 50686. Inother instances, the filter 50670 may consist of a single type offilter. In still other instances, the filter 50670 can include more thantwo filter layers and/or more than two different types of filter layers.After the particulate matter is removed by the filter layers 50684 and50686, the smoke is drawn through a carbon reservoir 50688 in the filter50670 to remove gaseous contaminants within the smoke, such as volatileorganic compounds, for example. In various instances, the carbonreservoir 50688 can comprise a charcoal filter. The filtered smoke,which is now substantially free of particulate matter and gaseouscontaminants, is drawn through the filter exhaust 50680 and into theevacuation system 50600 for further processing and/or elimination.

The filter 50670 includes a plurality of dams between components of thefilter body 50676. For example, a first dam 50690 is positionedintermediate the filter inlet 50678 (FIG. 10) and a first particulatefilter, such as the coarse media filter 50684, for example. A second dam50692 is positioned intermediate a second particulate filter, such asthe fine particulate filter 50686, for example, and the carbon reservoir50688. Additionally, a third dam 50694 is positioned intermediate thecarbon reservoir 50688 and the filter exhaust 50680. The dams 50690,50692, and 50694 can comprise a gasket or O-ring, which is configured toprevent movement of the components within the filter body 50676. Invarious instances, the size and shape of the dams 50690, 50692, and50694 can be selected to prevent distention of the filter components inthe direction of the applied suction.

The coarse media filter 50684 can include a low-air-resistant filtermaterial, such as fiberglass, polyester, and/or pleated filters that areconfigured to remove a majority of particulate matter larger than 10 μm,for example. In some aspects of the present disclosure, this includesfilters that remove at least 85% of particulate matter larger than 10μm, greater than 90% of particulate matter larger than 10 μm, greaterthan 95% of particular matter larger than 10 μm, greater than 99% ofparticular matter larger than 10 μm, greater than 99.9% particulatematter larger than 10 μm, or greater than 99.99% particulate matterlarger than 10 μm.

Additionally or alternatively, the coarse media filter 50684 can includea low-air-resistant filter that removes the majority of particulatematter greater than 1 μm. In some aspects of the present disclosure,this includes filters that remove at least 85% particulate matter largerthan 1 μm, greater than 90% of particulate matter larger than 1 μm,greater than 95% of particular matter larger than 1 μm, greater than 99%of particular matter larger than 1 μm, greater than 99.9% particulatematter larger than 1 μm, or greater than 99.99% particulate matterlarger than 1 μm.

The fine particulate filter 50686 can include any filter of higherefficiency than the coarse media filter 50684. This includes, forexample, filters that are capable of filtering a higher percentage ofthe same sized particles as the coarse media filter 50684 and/or capableof filtering smaller sized particles than the coarse media filter 50684.In some aspects of the present disclosure, the fine particulate filter50686 can include a HEPA filter or an ULPA filter. Additionally oralternatively, the fine particulate filter 50686 can be pleated toincrease the surface area thereof. In some aspects of the presentdisclosure, the coarse media filter 50684 includes a pleated HEPA filterand the fine particulate filter 50686 includes a pleated ULPA filter.

Subsequent to particulate filtration, smoke enters a downstream sectionof the filter 50670 that includes the carbon reservoir 50688. The carbonreservoir 50688 is bounded by porous dividers 50696 and 50698 disposedbetween the intermediate and terminal dams 50692 and 50694,respectively. In some aspects of the present disclosure, the porousdividers 50696 and 50698 are rigid and/or inflexible and define aconstant spatial volume for the carbon reservoir 50688.

The carbon reservoir 50688 can include additional sorbents that actcumulatively with or independently from the carbon particles to removegaseous pollutants. The additional sorbents can include, for example,sorbents such as magnesium oxide and/or copper oxide, for example, whichcan act to adsorb gaseous pollutants such as carbon monoxide, ethyleneoxide, and/or ozone, for example. In some aspects of the presentdisclosure, additional sorbents are dispersed throughout the reservoir50688 and/or are positioned in distinct layers above, below, or withinthe reservoir 50688.

Referring again to FIG. 4, the evacuation system 50500 includes the pump50506 within the evacuator housing 50518. Similarly, the evacuationsystem 50600 depicted in FIG. 7 can include a pump located in theevacuator housing 50618, which can generate suction to pull smoke fromthe surgical site, through the suction hose 50636 and through the filter50670 (FIGS. 10 and 11). In operation, the pump can create a pressuredifferential within the evacuator housing 50618 that causes the smoke totravel into the filter 50670 and out an exhaust mechanism (e.g. exhaustmechanism 50520 in FIG. 4) at the outlet of the flow path. The filter50670 is configured to extract harmful, foul, or otherwise unwantedparticulates from the smoke.

The pump can be disposed in-line with the flow path through theevacuator housing 50618 such that the gas flowing through the evacuatorhousing 50618 enters the pump at one end and exits the pump at the otherend. The pump can provide a sealed positive displacement flow path. Invarious instances, the pump can produce the sealed positive displacementflow path by trapping (sealing) a first volume of gas and decreasingthat volume to a second smaller volume as the gas moves through thepump. Decreasing the volume of the trapped gas increases the pressure ofthe gas. The second pressurized volume of gas can be released from thepump at a pump outlet. For example, the pump can be a compressor. Morespecifically, the pump can comprise a hybrid regenerative blower, a clawpump, a lobe compressor, and/or a scroll compressor. Positivedisplacement compressors can provide improved compression ratios andoperating pressures while limiting vibration and noise generated by theevacuation system 50600. Additionally or alternatively, the evacuationsystem 50600 can include a fan for moving fluid therethrough.

An example of a positive displacement compressor, e.g. a scrollcompressor pump 50650, is depicted in FIG. 12. The scroll compressorpump 50650 includes a stator scroll 50652 and a moving scroll 50654. Thestator scroll 50652 can be fixed in position while the moving scroll50654 orbits eccentrically. For example, the moving scroll 50654 canorbit eccentrically such that it rotates about the central longitudinalaxis of the stator scroll 50652. As depicted in FIG. 12, the centrallongitudinal axes of the stator scroll 50652 and the moving scroll 50654extend perpendicular to the viewing plane of the scrolls 50652, 50654.The stator scroll 50652 and the moving scroll 50654 are interleaved witheach other to form discrete sealed compression chambers 50656.

In use, a gas can enter the scroll compressor pump 50650 at an inlet50658. As the moving scroll 50654 orbits relative to the stator scroll50652, the inlet gas is first trapped in the compression chamber 50656.The compression chamber 50656 is configured to move a discrete volume ofgas along the spiral contour of the scrolls 50652 and 50654 toward thecenter of the scroll compressor pump 50650. The compression chamber50656 defines a sealed space in which the gas resides. Moreover, as themoving scroll 50654 moves the captured gas toward the center of thestator scroll 50652, the compression chamber 50656 decreases in volume.This decrease in volume increases the pressure of the gas inside thecompression chamber 50656. The gas inside the sealed compression chamber50656 is trapped while the volume decreases, thus pressurizing the gas.Once the pressurized gas reaches the center of the scroll compressorpump 50650, the pressurized gas is released through an outlet 50659.

Referring now to FIG. 13, a portion of an evacuation system 50700 isdepicted. The evacuation system 50700 can be similar in many respects tothe evacuation system 50600 (FIG. 7). For example, the evacuation system50700 includes the evacuator housing 50618 and the suction hose 50636.Referring again to FIG. 7, the evacuation system 50600 is configured toproduce suction and thereby draw smoke from the distal end of thesuction hose 50636 into the evacuator housing 50618 for processing.Notably, the suction hose 50636 is not connected to the evacuatorhousing 50618 through the filter end cap 50603 in FIG. 13. Rather, thesuction hose 50636 is connected to the evacuator housing 50618 throughthe fluid trap 50760. A filter, similar to the filter 50670 can bepositioned within the socket of the evacuator housing 50618 behind thefluid trap 50760.

The fluid trap 50760 is a first processing point that extracts andretains at least a portion of the fluid (e.g. liquid) from the smokebefore relaying the partially-processed smoke to the evacuation system50700 for further processing and filtration. The evacuation system 50700is configured to process, filter, and otherwise clean the smoke toreduce or eliminate unpleasant odors or other problems associated withsmoke generation in the surgical theater (or other operatingenvironment), as described herein. By extracting liquid droplets and/oraerosol from the smoke before it is further processed by the evacuationsystem 50700, the fluid trap 50760 can, among other things, increase theefficiency of the evacuation system 50700 and/or increase the life offilters associated therewith, in certain instances.

Referring primarily to FIGS. 14-17, the fluid trap 50760 is depicteddetached from the evacuator housing 50618 (FIG. 13). The fluid trap50760 includes an inlet port 50762 defined in a front cover or surface50764 of the fluid trap 50760. The inlet port 50762 can be configured toreleasably receive the suction hose 50636 (FIG. 13). For example, an endof the suction hose 50636 can be inserted at least partially within theinlet port 50762 and can be secured with an interference fittherebetween. In various instances, the interference fit can be a fluidtight and/or airtight fit so that substantially all of the smoke passingthrough the suction hose 50636 is transferred into the fluid trap 50760.In some instances, other mechanisms for coupling or joining the suctionhose 50636 to the inlet port 50762 can be employed such as a latch-basedcompression fitting, an O-ring, threadably coupling the suction hose50636 with the inlet port 50762, for example, and/or other couplingmechanisms.

In various instances, a fluid tight and/or airtight fit between thesuction hose 50636 and the fluid trap 50760 is configured to preventfluids and/or other materials in the evacuated smoke from leaking at ornear the junction of these components. In some instances, the suctionhose 50636 can be associated with the inlet port 50762 through anintermediate coupling device, such as an O-ring and/or adaptor, forexample, to further ensure an airtight and/or fluid tight connectionbetween the suction hose 50636 and the fluid trap 50760.

As discussed above, the fluid trap 50760 includes the exhaust port50766. The exhaust port extends away from a rear cover or surface 50768of the fluid trap 50760. The exhaust port 50766 defines an open channelbetween an interior chamber 50770 of the fluid trap 50760 and theexterior environment. In some instances, the exhaust port 50766 is sizedand shaped to tightly associate with a surgical evacuation system orcomponents thereof. For example, the exhaust port 50766 can be sized andshaped to associate with and communicate at least partially processedsmoke from the fluid trap 50760 to a filter housed within an evacuatorhousing 50618 (FIG. 13). In certain instances, the exhaust port 50766can extend away from the front plate, a top surface, or a side surfaceof the fluid trap 50760.

In certain instances, the exhaust port 50766 includes a membrane, whichspaces the exhaust port 50766 apart from the evacuator housing 50618.Such a membrane can act to prevent water or other liquid collected inthe fluid trap 50760 from being passed through the exhaust port 50766and into the evacuator housing 50618 while permitting air, water and/orvapor to freely pass into the evacuator housing 50618. For example, ahigh flow rate microporous polytetrafluoroethylene (PTFE) can bepositioned downstream of the exhaust port 50766 and upstream of a pumpto protect the pump or other components of the evacuation system 50700from damage and/or contamination.

The fluid trap 50760 also includes a gripping region 50772, which ispositioned and dimensioned to assist a user in handling the fluid trap50760 and/or connecting the fluid trap 50760 with the suction hose 50636and/or the evacuator housing 50618. The gripping region 50772 isdepicted as being an elongate recess; however, the reader will readilyappreciate that the gripping region 50772 may include at least onerecess, groove, protrusion, tassel, and/or ring, for example, which canbe sized and shaped to accommodate a user's digits or to otherwiseprovide a gripping surface.

Referring primarily now to FIGS. 16 and 17, the interior chamber 50770of the fluid trap 50760 is depicted. The relative positioning of theinlet port 50762 and the exhaust port 50766 is configured to promote theextraction and the retention of fluid from the smoke as it passes intothe fluid trap 50760. In certain instances, the inlet port 50762 cancomprise a notched cylindrical shape, which can direct the smoke and theaccompanying fluid towards a fluid reservoir 50774 of the fluid trap50760 or otherwise directionally away from the exhaust port 50766. Anexample of such a fluid flow is depicted with arrows A, B, C, D, and Ein FIG. 17.

As shown, smoke enters the fluid trap 50760 through the inlet port 50762(illustrated by the arrow A) and exits the fluid trap 50760 through theexhaust port 50766 (illustrated by the arrow E). At least partially dueto the geometry of the inlet port (e.g., a longer, upper sidewall 50761and a shorter, lower sidewall 50763), the smoke entering the inlet port50762 is initially directed primarily downward into the fluid reservoir50774 of the fluid trap 50760 (illustrated by the arrows B). As smokecontinues to be pulled downward into the fluid trap 50760 along thearrows A and B, the smoke that was initially directed downward, tumblesdownward, and is directed laterally away from its source to travel in asubstantially opposite but parallel path towards the upper portion ofthe fluid trap 50760 and out of the exhaust port 50766 (illustrated bythe arrows D and E).

The directional flow of smoke through the fluid trap 50760 can ensurethat liquids within the smoke are extracted and retained within thelower portion (e.g. the fluid reservoir 50774) of the fluid trap 50760.Furthermore, the relative positioning of the exhaust port 50766vertically above the inlet port 50762 when the fluid trap 50760 is in anupright position is configured to discourage liquid from inadvertentlybeing carried through the exhaust port 50766 by the flow of smoke whilenot substantially hindering fluid flow into and out of the fluid trap50760. Additionally, in certain instances, the configuration of theinlet port 50762 and the outlet port 50766 and/or the size and shape ofthe fluid trap 50760 itself, can enable the fluid trap 50760 to be spillresistant.

In various instances, an evacuation system can include a plurality ofsensors and intelligent controls, as further described herein withrespect to FIGS. 5 and 6, for example. In one aspect of the presentdisclosure, an evacuation system can include one or more temperaturessensors, one or more fluid detection sensors, one or more pressuresensors, one or more particle sensors, and/or one or more chemicalsensors. A temperature sensor can be positioned to detect thetemperature of a fluid at the surgical site, moving through a surgicalevacuation system, and/or being exhaust into a surgical theater from asurgical evacuation system. A pressure sensor can be positioned todetect a pressure within the evacuation system, such as within theevacuator housing. For example, a pressure sensor can be positionedupstream of the filter, between the filter and the pump, and/ordownstream of the pump. In certain instances, a pressure sensor can bepositioned to detect a pressure in the ambient environment outside ofthe evacuation system. Similarly, a particle sensor can be positioned todetect particles within the evacuation system, such as within theevacuator housing. A particle sensor can be upstream of the filter,between the filter and the pump, and/or downstream of the pump, forexample. In various instances, a particle sensor can be positioned todetect particles in the ambient environment in order to determine theair quality in the surgical theater, for example.

An evacuator housing 50818 for an evacuation system 50800 isschematically depicted in FIG. 18. The evacuator housing 50818 can besimilar in many respects to the evacuator housings 50018 and/or 50618,for example, and/or can be incorporated into various evacuation systemsdisclosed herein. The evacuator housing 50818 includes numerous sensors,which are further described herein. The reader will appreciate thatcertain evacuator housings may not include each sensor depicted in FIG.18 and/or may include additional sensor(s). Similar to the evacuatorhousings 50018 and 50618 disclosed herein, the evacuator housing 50818of FIG. 18 includes an inlet 50822 and an outlet 50824. A fluid trap50860, a filter 50870, and a pump 50806 are sequentially aligned along aflow path 50804 through the evacuator housing 50818 between the inlet50822 and the outlet 50824.

An evacuator housing can include modular and/or replaceable components,as further described herein. For example, an evacuator housing caninclude a socket or a receptacle 50871 dimensioned to receive a modularfluid trap and/or a replaceable filter. In certain instances, a fluidtrap and a filter can be incorporated into a single interchangeablemodule 50859, as depicted in FIG. 18. More specifically, the fluid trap50860 and the filter 50870 form the interchangeable module 50859, whichcan be modular and/or replaceable, and can be removably installed in thereceptacle 50871 in the evacuator housing 50818. In other instances, thefluid trap 50860 and the filter 50870 can be separate and distinctmodular components, which can be assembled together and/or separatelyinstalled in the evacuator housing 50818.

Referring still to the evacuator housing 50818, the evacuator housing50818 includes a plurality of sensors for detecting various parameterstherein and/or parameters of the ambient environment. Additionally oralternatively, one or more modular components installed in the evacuatorhousing 50818 can include one or more sensors. For example, referringstill to FIG. 18, the interchangeable module 50859 includes a pluralityof sensors for detecting various parameters therein.

In various instances, the evacuator housing 50818 and/or a modularcomponent(s) compatible with the evacuator housing 50818 can include aprocessor, such as the processor 50308 and 50408 (FIGS. 5 and 6,respectively), which is configured to receive inputs from one or moresensors and/or to communicate outputs to one more systems and/ordrivers. Various processors for use with the evacuator housing 50818 arefurther described herein.

In operation, smoke from a surgical site can be drawn into the inlet50822 to the evacuator housing 50818 via the fluid trap 50860. The flowpath 50804 through the evacuator housing 50818 in FIG. 18 can comprise asealed conduit or tube 50805 extending between the various in-linecomponents. In various instances, the smoke can flow past a fluiddetection sensor 50830 and a chemical sensor 50832 to a diverter valve50834, which is further described herein. A fluid detection sensor, suchas the sensor 50830, can detect fluid particles in the smoke. In oneinstance, the fluid detection sensor 50830 can be a continuity sensor.For example, the fluid detection sensor 50830 can include twospaced-apart electrodes and a sensor for detecting the degree ofcontinuity therebetween. When no fluid is present, the continuity can bezero, or substantially zero, for example. The chemical sensor 50832 candetect the chemical properties of the smoke.

At the diverter valve 50834, fluid can be directed into a condenser50835 of the fluid trap 50860 and the smoke can continue toward thefilter 50870. Baffles 50864 are positioned within the condenser 50835 tofacilitate the condensation of fluid droplets from the smoke into areservoir in the fluid trap 50860. A fluid detection sensor 50836 canensure any fluid in the evacuator housing is entirely, or at leastsubstantially, captured within the fluid trap 50860.

Referring still to FIG. 18, the smoke can then be directed to flow intothe filter 50870 of the interchangeable module 50859. At the inlet tothe filter 50870, the smoke can flow past a particle sensor 50838 and apressure sensor 50840. In one form, the particle sensor 50838 cancomprise a laser particle counter, as further described herein. Thesmoke can be filtered via a pleated ultra-low penetration air (ULPA)filter 50842 and a charcoal filter 50844, as depicted in FIG. 18.

Upon exiting the filter, the filtered smoke can flow past a pressuresensor 50846 and can then continue along the flow path 50804 within theevacuator housing 50818 toward the pump 50806. Upon moving through thepump 50806, the filtered smoke can flow past a particle sensor 50848 anda pressure sensor 50850 at the outlet to the evacuator housing 50818. Inone form, the particle sensor 50848 can comprise a laser particlecounter, as further described herein. The evacuator housing 50818 inFIG. 18 also includes an air quality particle sensor 50852 and anambient pressure sensor 50854 to detect various properties of theambient environment, such as the environment within the surgicaltheater. The air quality particle sensor, or external/ambient airparticle sensor, 50852 can comprise a laser particle counter in at leastone form. The various sensors depicted in FIG. 18 are further describedherein. Moreover, in various instances, alternative sensing means can beutilized in the smoke evacuation systems disclosed herein. For example,alternative sensors for counting particles and/or determiningparticulate concentration in a fluid are further disclosed herein.

In various instances, the fluid trap 50860 depicted in FIG. 18 can beconfigured to prevent spillage and/or leakage of the captured fluid. Forexample, the geometry of the fluid trap 50860 can be selected to preventthe captured fluid from spilling and/or leaking. In certain instances,the fluid trap 50860 can include baffles and/or splatter screens, suchas the screen 50862, for preventing the captured fluid from splashingout of the fluid trap 50860. In one or more instances, the fluid trap50860 can include sensors for detecting the volume of fluid within thefluid trap and/or determining if the fluid trap 50860 is filled tocapacity. The fluid trap 50860 may include a valve for empty the fluidtherefrom. The reader will readily appreciate that various alternativefluid trap arrangements and geometries can be employed to capture fluiddrawn into the evacuator housing 50818.

In certain instances, the filter 50870 can include additional and/orfewer filtering levels. For example, the filter 50870 can include one ormore filtering layers selected from the following group of filters: acourse media filter, a fine media filter, and a sorbent-based filter.The course media filter can be a low-air-resistant filter, which can becomprised of fiberglass, polyester, and/or pleated filters, for example.The fine media filter can be a high efficiency particulate air (HEPA)filter and/or ULPA filter. The sorbent-based filter can be anactivated-carbon filter, for example. The reader will readily appreciatethat various alternative filter arrangements and geometries can beemployed to filter smoke drawn along the flow path through the evacuatorhousing 50818.

In one or more instances, the pump 50806 depicted in FIG. 18 can bereplaced by and/or used in combination with another compressor and/orpump, such as a hybrid regenerative blower, a claw pump, and/or a lobecompressor, for example. The reader will readily appreciate that variousalternative pumping arrangements and geometries can be employed togenerate suction within the flow path 50804 to draw smoke into theevacuator housing 50818.

The various sensors in an evacuation system, such as the sensorsdepicted in FIG. 18, can communicate with a processor. The processor canbe incorporated into the evacuation system and/or can be a component ofanother surgical instrument and/or a surgical hub. Various processorsare further described herein. An on-board processor can be configured toadjust one or more operational parameters of the evacuator system (e.g.a motor for the pump 50806) based on input from the sensor(s).Additionally or alternatively, an on-board processor can be configuredto adjust one or more operational parameters of another device, such asan electrosurgical tool and/or imaging device based on input from thesensor(s).

Referring now to FIG. 19, another evacuator housing 50918 for anevacuation system 50900 is depicted. The evacuator housing 50918 in FIG.19 can be similar in many respects to the evacuator housing 50818 inFIG. 18. For example, the evacuator housing 50918 defines a flow path50904 between an inlet 50922 to the evacuator housing 50918 and anoutlet 50924 to the evacuator housing 50918. Intermediate the inlet50922 and the outlet 50924, a fluid trap 50960, a filter 50970, and apump 50906 are sequentially arranged. The evacuator housing 50918 caninclude a socket or a receptacle 50971 dimensioned to receive a modularfluid trap and/or a replaceable filter, similar to the receptacle 50871,for example. At a diverter valve 50934, fluid can be directed into acondenser 50935 of the fluid trap 50960 and the smoke can continuetoward the filter 50970. In certain instances, the fluid trap 50960 caninclude baffles, such as the baffles 50964, and/or splatter screens,such as the screen 50962, for example, for preventing the captured fluidfrom splashing out of the fluid trap 50960. The filter 50970 includes apleated ultra-low penetration air (ULPA) filter 50942 and a charcoalfilter 50944. A sealed conduit or tube 50905 extends between the variousin-line components. The evacuator housing 50918 also includes thesensors 50830, 50832, 50836, 50838, 50840, 50846, 50848, 50850, 50852,and 50854 which are further described herein and shown in FIG. 18 andFIG. 19.

Referring still to FIG. 19, the evacuator housing 50918 also includes acentrifugal blower arrangement 50980 and a recirculating valve 50990.The recirculating valve 50990 can selectively open and close torecirculate fluid through the fluid trap 50960. For example, if thefluid detection sensor 50836 detects a fluid, the recirculating valve50990 can be opened such that the fluid is directed back away from thefilter 50970 and back into the fluid trap 50960. If the fluid detectionsensor 50836 does not detect a fluid, the valve 50990 can be closed suchthat the smoke is directed into the filter 50970. When fluid isrecirculated via the recirculating valve 50990, the fluid can be drawnthrough a recirculation conduit 50982. The centrifugal blowerarrangement 50980 is engaged with the recirculation conduit 50982 togenerate a recirculating suction force in the recirculation conduit50982. More specifically, when the recirculating valve 50990 is open andthe pump 50906 is activated, the suction force generated by the pump50906 downstream of the filter 50970 can generate rotation of the firstcentrifugal blower, or squirrel cage, 50984, which can be transferred tothe second centrifugal blower, or squirrel cage, 50986, which draws therecirculated fluid through the recirculating valve 50990 and into thefluid trap 50960.

In various aspects of the present disclosure, the control schematics ofFIGS. 5 and 6 can be utilized with the various sensor systems andevacuator housings of FIGS. 18 and 19.

Communication of Smoke Evacuation System Parameters to Surgical Hub orCloud to Effect the Output or Operation of Other Attached DevicesEND8546USNP (M-1/164469)

During the course of surgical procedures in which electrosurgicalinstruments have been used, parameters such as the type of particles,the particle concentration, and particle size in surgical smoke have notpreviously been monitored. This lack of smoke monitoring during thesurgical procedures implies that smoke evacuation devices present atsurgical sites have failed to adjust operation to more carefullyevacuate the smoke in order to compensate as parameters change over thecourse of the surgical procedure (e.g., higher particle concentration insmoke being evacuated, etc.).

With reference to FIGS. 20-22 and FIGS. 25-35, an example smart smokeevacuation system 56100 as described herein is able to communicatedetected or sensed parameters to a surgical hub 206 or a cloud analyticscomputing environment 204 (the cloud 204 hereafter), which in turneffects the output and operation of other devices in communication withthe surgical hub 206 or the cloud 204. For example, if a varied particleconcentration is detected, this varied parameter is communicated to thesurgical hub 206 or the cloud 204, and the surgical hub 206 or the cloud204 may adjust operation of another component in the smart smokeevacuation system 56100, such as the power level applied to theelectrosurgical instrument, to compensate for the varied parameter.

By automatically adjusting operation of other devices due to parametersdetected by the smart smoke evacuation system, smoke produced byoperation of an electrosurgical instrument is more effectively removed,and the danger to physicians and other personnel present during surgicalprocedures is decreased.

FIG. 20 illustrates a smoke evacuation system 56100, in which thevarious modules and devices are in communication with one another, inaccordance with at least one aspect of the present disclosure.Communication between the modules and devices identified in smokeevacuation system 56100 may occur directly or indirectly via aconnection through the surgical hub 204 and/or the cloud 204. The smokeevacuation system 56100 can be interactively coupled to the surgical hub206 and/or the cloud 204 as described, for example, in FIGS. 25-35. Inthis manner, parameters sensed or detected by a smoke evacuation module226 may impact the functionality of other modules, devices, orcomponents in a computer implemented surgical system, such as thoseillustrated in FIGS. 32-24. FIG. 20, for example, depicts a computerimplemented smoke evacuation system 56100 comprising a cloud 204, asurgical hub 206, a smoke evacuation module 226, and module A 56108,module B 56106, and module C 56104. Modules A 56108, B 56106, and C56104 may be any of the modules or devices that are in communicationwith, or a part of, the surgical hub 206. For example, modules A 56108,B 56106, and C 56104 may be components of, the visualization system 208,components of the robotic system 222, an intelligent instrument 235, animaging module 238, a generator module 240, a suction/irrigation module228, a communication module 230, a processor module 232, a storage array234, an operating-room mapping module 242, etc. Examples anddescriptions of these various types of modules and components may befound in, for example, discussion of FIGS. 25-35.

The smoke evacuation module 226 comprises at least one sensor. Thissensor can be any type of sensor, including, for example, sensorsdetecting operational parameters such as ambient pressure sensors, airquality particle sensors, etc. Further the sensors can be internalsensors such as, for example, a pressure sensor, a fluid detectionsensor, a chemical sensor, a laser particle counter, etc. Further, morethan one pressure sensor may be included in the smoke evacuation module226 in order to determine a pressure differential across variousportions of the smoke evacuation module 226. A description of sensorsused in the context of a smoke evacuation system 56100 may be found inconnection with FIGS. 4-6, 18, and 19, for example.

In various aspects, the smoke evacuation module 226 and modules A 56108,B 56106, and C 56104 may be in direct or indirect communication with thesurgical hub 206 and/or the cloud 204, for example. Turning back to FIG.20, the smoke evacuation module 206 and modules A 56108, B 56106, and C56104 are depicted as engaging in two way communication with thesurgical hub 206. This two way communication is indicated by twodirectional arrows, such as arrow 56112. This two directionalcommunication may be accomplished, in an example, by connecting themodular housing of the smoke evacuation module 226 or modules A 56108, B56106, and C 56104 to a modular backplane comprising an inner connectorconsole. The modular backplane is configured to laterally or verticallyconnect to the modular housing of the smoke evacuation module 226 ormodules A 56108, B 56106, and C 56104 with the surgical hub 206. Anexample of this is shown in FIGS. 27-31. In an alternate example, twoway communication may be established by the housing of the smokeevacuation module 226 or modules A 56108, B 56106, and C 56104 being astand alone housing that has a wired connection attachment on the backof the device that would allow it to interface with surgical hub 206.Alternatively, in another example, the smoke evacuation module 226 andmodules A 56108, B 56106, and C 56104 may be connected directly to eachother. In yet another example, the smoke evacuation module 226 andmodules A 56108, B 56106, and C 56104 may comprise a wirelesscommunication module to communicate with the surgical hub 206 and/or thecloud 204, either directly or indirectly. In the example illustrated inFIG. 20, the surgical hub 206 is depicted as being in two waycommunication with the cloud 204. Alternatively, in another example, thesmoke evacuation module 226, as indicated by the broken line 56110, andalso any one of or all of the modules A 56108, B 56106, and C 56104, maybe directly in communication with the cloud 204 in order to receiveinstructions or information directly from the cloud without proceedingthrough the surgical hub 206.

FIG. 21 depicts an example method flow diagram 56200 ofinterconnectivity between the surgical hub 206, the cloud 204, the smokeevacuation module 226, and/or various other modules A 56108, B 56106,and C 56104, in accordance with at least one aspect of the presentdisclosure. Although the example method 56200 is described withreference to the flowchart illustrated in FIG. 21, it will beappreciated that many other methods of performing the acts associatedwith the method may be used. For example, the order of some of theblocks may be changed, certain blocks may be combined with other blocks,and some of the blocks described are optional.

With reference also to FIGS. 25-35, initially, a parameter is acquired56202 by the smoke evacuation module 226. For example, a sensorcomponent of the smoke evacuation module 226, such as the air qualityparticle sensor, will detect a parameter. This parameter may be anyparameter related to the ambient environment of the surgical theater,such as, for example, the air quality of the surgical theater. Althoughin this example there is only one sensed parameter, this disclosureshould not be limited in such a manner. In an alternate example, theremay be many sensed parameters by any number of different sensors. Howfrequently the parameters are sensed, and how frequently the smokeevacuation module 226 is activated, is dependent upon the amount ofsmoke being evacuated. For example, if very little smoke is beingevacuated, then the smoke evacuation module 226 may run more slowlyand/or sense parameters less frequently. Alternatively, if the smokeevacuation module 226 is actively working to evacuate smoke that israpidly being produced, it may be helpful for the smoke evacuationmodule 226 to run at a higher rate and/or sense parameters morefrequently to ensure that the equipment is properly functioning. Thismay provide a safer environment for all surgeons, personnel, and medicalequipment present in the surgical theater. Other parameters that may besensed include those sensed by internal sensors, such as, for example,particulate concentration, aerosol percentage, or chemical analysis.Alternatively, operational parameters sensed by sensors on the smokeevacuation module 226 housing include, for example, air flow, pressuredifferentials, or air quality. A description of sensors used in thecontext of the smoke evacuation system 56100 may be found at FIGS. 4-6,18, and 19, for example.

Next, the smoke evacuation module 226 will transmit 56204 the value ofthis acquired parameter to the surgical hub 206 or the cloud 204. Forexample, if the value of the air quality of the surgical theater isacquired, it may be sent by the smoke evacuation module 226 to thesurgical hub 206. The surgical hub 206 either may process the parameter,and/or it may communicate the received air quality parameter to thecloud 204. This may be accomplished via a network router 211, networkhub 207, network switch 209, or any combination thereof. In an alternateexample, the smoke evacuation module 226 may communicate the air qualityparameter directly to the cloud 204 using wired or wirelesscommunication techniques.

Next, the value of the parameter is processed 56206, and it isdetermined 56208 whether the value of the parameter has an impact on theway the surgical evacuation system 56100 or another modular deviceshould operate. This processing may occur in the surgical hub 206, inthe cloud 204, or a combination of the surgical hub 206 and the cloud204. The processing performed on the sensed parameter includes using thevalue of the sensed parameter in various algorithms and learningsoftware to determine if operation of the smoke evacuation module 226 orany of modules A 56108, B 56106, and C 56104 should be automaticallyadjusted to compensate for the value of the parameter that was detected.The value of the parameter is a smoke evacuation variable. Thealgorithms and learning software may be stored in the cloud 204 (storage105) or surgical hub 206 (storage 248) prior to processing, and may beremotely updated as needed.

For example, if the value of the sensed air quality parameter indicatesa large quantity of smoke particles in the air, the cloud 204 maycontain software algorithms that can use the value of the air qualityparameter to determine how to alter the operation of the smokeevacuation module or modules A 56108, B 56106, and C 56104 in order toimprove the ambient air quality of the surgical theater. In the example,the cloud 204 may determine that the operation of an intelligentinstrument 235 must be modified, and this operation is best adjusted byadjusting the output of the generator supplying waveforms to theintelligent instrument 235. A generator module 240 converts theelectricity to high frequency waveforms comprised of oscillatingelectric currents, which are transmitted to the electrodes to effecttissue. In an alternate example, the cloud 204 may determine that noneof modules A 56108, B 56106, and C 56104 must be adjusted, but that theoperation of the smoke evacuation module 226 must be adjusted. In thisalternate example, the cloud 204 may determine that the value of the airquality parameter indicates that the smoke evacuation module 226 mayprovide a safer environment if operation of the smoke evacuation module226 is adjusted in order to evacuate smoke from the operating theatermore quickly.

Next, an instruction is sent 56210 to the surgical evacuation system56100 or the modular device to adjust operation. For example, the cloud204 may determine that based off the value of the sensed air qualityparameter, the operation of the intelligent instrument 235 should beadjusted. In the example, this was previously determined by the cloud204 to be best effectuated by modifying the output of the generatormodule 240. Therefore, in this example step 56210, the cloud 204 sendsan instruction to the generator module 240 (e.g., module A 56108). Inthe example, an instruction is sent to the generator module 240 thatdirects the output of the generator module 240 to be modified in orderto change the operation of the intelligent instrument 235.

Finally, operation of the surgical evacuation system 56100 or themodular device is adjusted 56212 based on the instruction. For example,the generator module 240 will comply with the instruction it receivedfrom the cloud 204, and change the shape of the waveform output to theintelligent instrument 235. This adjustment causes the intelligentinstrument 235 to effect tissue in a desired manner. In an example, theinstructions to the various modules are pre-stored in the cloud 204 orthe surgical hub 206, but may be updated remotely as needed.Alternatively, these instructions are dynamically generated by the cloud204 or the surgical hub 206 as needed.

FIG. 22 illustrates a smoke evacuation system 56300 in communicationwith various other modules and devices, in accordance with at least oneaspect of the present disclosure. The example illustrated in FIG. 22discloses an alternative example of the computer implemented surgicalsystem shown in FIG. 20. With continued reference to FIGS. 25-35 and toFIG. 22, a cloud 204 and a surgical hub 206 are depicted. Although theillustrated example depicts one cloud 204 and one surgical hub 206, inalternate examples there may be more than one cloud 204 and/or surgicalhub 206 in the computer implemented surgical system.

In FIG. 22, the surgical hub 206 may include various modules, such as asuction/irrigation module 228, a smoke evacuation module 226, and agenerator module 240. The smoke evacuation module 226 may contain afirst sensor 56302 and a second sensor 56304 that detect differentparameters. For example, the first sensor 56302 may be a chemical sensorperforming a chemical analysis on the smoke being evacuated from asurgical theater, and the second sensor 56304 may be a laser particlecounter determining particle concentration of the smoke being evacuatedfrom the surgical theater. In an alternate example, there may be more orless than two sensors in the smoke evacuation module 226.

In the example, the first sensor 56302 senses a first parameter 56306,for example, the pH of the smoke being evacuated from the surgicaltheater. The second sensor 56304 senses a second parameter 56308, forexample, particle count (parts per million) of the smoke being evacuatedfrom the surgical theater. The smoke evacuation module 226 may beconnected to surgical hub 206, or may be a part of the surgical hub 206,and therefore the first parameter 56306 and the second parameter 56308may be provided to the surgical hub 206 automatically after beingsensed. In an alternate example, the surgical hub 206 may request anysensed parameters periodically from the smoke evacuation module 226, orupon a user request for sensed parameter information, and the smokeevacuation module 226 will provide the values of sensed parameters uponrequest. Alternatively, the smoke evacuation module 226 may providesensed values to the surgical hub 206 periodically without beingrequested.

In an example, the surgical hub 206 may process, modify, or manipulatethe first parameter 56306 and the second parameter 56308 to become afirst processed parameter 56306′ and a second processed parameter56308′. In an alternate example, the surgical hub 206 may not performany processing of the first parameter 56306 and the second parameter56308. The surgical hub 206 may send the first processed parameter56306′ and the second processed parameter 56308′ to the cloud 204 forfurther processing in order to determine whether operation of thevarious modules should be adjusted based on the values of the sensedparameters. The cloud 204 may run a variety of algorithms to determineif the values of the first processed parameter 56306′ and the secondprocessed parameter 56308′ indicate whether any of the other modules anddevices, including the smoke evacuation module 226, should adjustoperation in order to create a more ideal surgical environment in thesurgical theater. The cloud 204 may, in this example, determine that thevalues of the first processed parameter 56306′ and the second processedparameter 56308′ are either above or below acceptable thresholds, andtherefore operation of other modules should be adjusted to compensatefor the sensed/detected values of the first processed parameter 56306′and the second processed parameter 56308′.

In the example shown in FIG. 22, the cloud 204 may determine that thedisplay of the visualization system 208 should be adjusted to accuratelydepict the surgical site. In this case, the cloud 204 may send aninstruction A 56312 to the visualization system 208 to adjust itsdisplay of the surgical site. The visualization system 208 iscommunicatively coupled to the surgical hub 206.

Further, in the example, the cloud 204 may determine after running avariety of algorithms that the operation of the suction/irrigationmodule 228 should also be adjusted based on either the value of thefirst processed parameter 56306′ or the second processed parameter56308′. In the example, an instruction B 56310 may be sent to thesurgical hub 206 from the cloud 204. The surgical hub 206 may transmitthe instruction B 56310 to the suction/irrigation module 228. In analternative example, the surgical hub 206 may cause the processor 244located in surgical hub 206 to adjust the operation of thesuction/irrigation module 228. In another alternate example, the cloud204 may send the instruction B 56310 directly to the suction/irrigationmodule 228 without first sending the instruction B 56310 through thesurgical hub 206.

The cloud 204 may determine after running various algorithms that thegenerator module 240 may not benefit from an adjustment in operation, orthat the sensed parameters may not be effectively influenced from anadjustment in operation of the generator module 240. Therefore, in theexample illustrated in FIG. 22, the cloud 204 may not send aninstruction to the generator module 240. Alternatively, the cloud 204may send the generator module 240 an indication that no modification inoperation is necessary.

Smoke Evacuation System Containing a Segmented Control Circuit where theCircuit is Energized in a Staged Method to Check for Errors, Shorts, andSafety Checks of the System END8546USNP1 (M-7/162220)

If faults in the smoke evacuation system are undetected, the smokeevacuation system may be unknowingly operated in a surgical context whenthe evacuation system is not functioning properly. This may cause anunsafe surgical environment where dangerous or carcinogenic smoke is notproperly being filtered out of an operating theater. Alternatively,although some portions of a smoke evacuation system may be properlyfunctioning, other portions may not be properly functioning. This mayrender the smoke evacuation system generally dangerous to energize andoperate.

The smoke evacuation system 56100, 56300 comprising a smoke evacuationmodule 226 coupled to the surgical hub 206 and/or the cloud 204 asdescribed in FIGS. 20-22, for example, may further comprise a segmentedcontrol circuit 57100 as described in FIG. 23. The segmented controlcircuit 57100 may be energized in stages to check for faults, errors,shorts, and may run a variety of safety checks while starting up thesmoke evacuation module 226 to help determine that the smoke evacuationmodule 226 is safe to operate.

By starting the smoke evacuation module 226 in a staged method, faultsand errors may be identified before attempting to operate the smokeevacuation module 226. This may improve the overall safety of thesurgical operation as the smoke evacuation system may be repaired, or ifnecessary, a replaced with a replacement smoke evacuation module.

In one aspect, the smoke evacuation module 226 described in FIGS. 20-22comprises a segmented control circuit where the circuit may be energizedin a staged method to check for errors, shorts, and perform safetychecks of the system. FIG. 23 illustrates one aspect of a segmentedcontrol circuit 57100, in accordance with at least aspect of the presentdisclosure. It should be noted that although certain features, modules,processors, motors, etc. are grouped in various segments depicted inFIG. 23, the disclosure should not be limited to this example. Inalternative examples, the segments may include more, less, or differentcomponents than those disclosed in FIG. 23. Further, in anotheralternate example, the number of segments in the example segmentedcircuit may be more or less than three segments.

In the example of FIG. 23, the segmented control circuit 57100 includesa first segment 57102, a second segment 57104, and a third segment57106. In an example, the first segment 57102 includes a main processor57108 and a safety processor 57110. The main processor 57108 may bedirectly wired to a power button or switch 57120. Therefore, in thisexample, the first segment 57102, and specifically the main processor57108, is the first segment 57102 and component 57108 to be activated.

The safety processor 57110 and/or the main processor 57108 may beconfigured to interact with one or more additional circuit segments andtheir components, such as the second segment 57104, which may includesensing circuit 57112 and display circuit 57114, and the third segment57106, which may include a motor control circuit 57116 and a motor57118. Each of the circuit segments and their components may be coupledto or in communication with the safety processor 57110 and/or the mainprocessor 57108. The main processor 57108 and/or the safety processor57110 may also be coupled to a memory, or include an internal memory.The main processor 57108 and/or the safety processor 57110 may also becoupled to or in wired or wireless communication with a communicationdevice that will allow communication over a network such as the surgicalhub 206 and/or the cloud 204.

The main processor 57108 may comprise a plurality of inputs coupled to,for example, one or more circuit segments, a battery, and/or a pluralityof switches. The segmented control circuit 57100 may be implemented byany suitable circuit, such as, for example, a printed circuit boardassembly (PCBA) within the smoke evacuation module 226. It should beunderstood that the term processor as used herein includes anymicroprocessor, processors, controller, controllers, or other basiccomputing device that incorporates the functions of a computer's centralprocessing unit (CPU) on an integrated circuit or, at most, a fewintegrated circuits. The main processor 57108 and safety processor 57110are multipurpose, programmable devices that accept digital data asinput, processes it according to instructions stored in its memory, andprovides results as output. It is an example of sequential digitallogic, as it has internal memory. The safety processor 57110 may beconfigured specifically for safety critical applications, among others,to provide advanced integrated safety features while delivering scalableperformance, connectivity, and memory options.

In the example shown in FIG. 23, the second segment 57104 may comprise asensing circuit 57112 and a display circuit 57114 both coupled to or insignal communication with the main processor 57108. The sensing circuit57112 of the smoke evacuation module 226 described generally hereinincludes various sensors, some being internal to the smoke evacuationmodule 226 and some being external and located on the housing of thesmoke evacuation module 226. These sensors include various pressuresensors, fluid sensors, chemical sensors, laser particle counters orother laser sensors, and air quality sensors. A description of sensorsused in the context of the smoke evacuation system 56100 may be found atFIGS. 4-6, 18, and 19, for example.

In an alternate aspect, the sensing circuit 57112 may include acommunication device as some sensors located on the external housing ofthe smoke evacuation module 226 may involve communication with and/orconnectivity to the sensing circuit 57112, the main processor 57108,and/or the safety processor 57102 via the communication device. Thedisplay circuit 57114 may include a screen or other display that maydisplay text, images, graphs, charts, etc. obtained by the smokeevacuation module 226 or another device in communication with the smokeevacuation module 226 or the surgical hub 206. For example, the displaycircuit 57114 may include a monitor or screen (e.g., display 210, 217 ormonitor 135) that may display and overlay images or data received fromthe imaging module 238, the device/instrument 235, and/or othervisualization systems 208. This display or screen may present to theuser the status of each segment, or status of each component in eachsegment, in the segmented control circuit 57100. The status of eachsegment, or the status of each component of each segment, may bediscerned by the segmented control circuit 57100 by identifying eachcomponent or segment, receiving or determining a status of eachcomponent or segment, and displaying the status to the user for eachcomponent or segment. A component or segment may be identified using,for example, a unique data packet format, an authentication, anencryption, an ID number, a password, a signal communication, a flag,etc. A status of a component or segment may be determined using a flag,an indication, a value of a sensed parameter, a measurement, etc.

These functions (identification, determination, and display) may beperformed using, for example, a wired connection, signal communication,Thread, Bluetooth, RFID, or NFC. For example, components of segmentedcontrol circuit 57100 may include a communication device to communicateover a network, or may be coupled to an external communication deviceallowing for communication over a network. The communication devices mayinclude a transceiver configured to communicate over physical wires orwirelessly. The device may further include one or more additionaltransceivers. The transceivers may include, but are not limited tocellular modems, wireless mesh network transceivers, Wi-Fi®transceivers, low power wide area (LPWA) transceivers, and/or near fieldcommunications transceivers (NFC). The communication device may includeor may be configured to communicate with the main processor 57108, thesafety processor 57110, the display circuit 57114, the surgical hub 206,or the cloud 204, which may verify the identities of, or may receive theidentities of, the components and their associated status. Thetransceivers may be configured to receive serial transmit data viarespective UARTs, from the processor, to modulate the serial transmitdata onto an RF carrier to produce a transmit RF signal and to transmitthe RF signal via respective antennas. Each transceiver may correspondto an implementation of a selected wireless communication standardand/or protocol, e.g., IEEE 802.11 a/b/g/n for Wi-Fi® and/or IEEE802.15.4 for wireless mesh networks using Zigbee routing, as describedherein. In alternative aspects, the display circuit may include a smallspeaker to audibly signal or a small light/display to indicate thestatus of the smoke detector, an on/off operation, filter liferemaining, etc. Identification of each component and their status may beprovided voluntarily by each component, sending or transmitting suchinformation at regular or irregular time intervals. An example of anirregular time interval may be, for example, when a user directsinformation to be sent. In an alternate example, the identity and statusinformation of each component or segment may be requested at regular orirregular time intervals. For example, an identity and status of themotor control circuit 57116 may be requested every 1 minute, 20 minutes,40 minutes, one hour, 3 hours, 24 hours, etc.

In an alternate aspect, the segmented control circuit 57100 allows forthe energizing of a status circuit that allows the smoke evacuationmodule 226 to query or poll all attached components. The status circuitmay be located in any of the segments, but for this example may belocated in the first segment 57102. This status circuit may be able toquery/poll all components, including those components in the firstsegment 57102, the second segment 57104, the third segment 57106, aswell as any other additional components such as those depicted in FIGS.25-35. The polling/querying of the attached components may be done inorder to verify compatibility, that the component or segment may becompatible with the smoke evacuation system or hub; authenticity, thatthe component or segment may be the correct component and can betrusted; used status, or the status of any segment or component that hasa life span based on use, such as a filter; and correct insertion of thesegment or component, such as correctly inserting a filter beforeenergizing the motor and the pump connected to the motor. In an example,the intelligent instrument, such as intelligent instrument 235, mayfurther be queried/polled in order to verify that the proper devices arebeing used and that the smoke evacuator system is able to function, orknows how to function, with the polled/queried intelligent instrument.For example, the intelligent instrument 235 polled or queried may be aZip Pen®. Knowing which Zip Pen® is being used may help the smokeevacuation system determine how to function. If an unidentifiedintelligent instrument is being used, the smoke evacuation system maydetermine energizing the motor is inappropriate or unsafe and an errormay be displayed by the display circuit 57114. This may be done for anycomponent of the smart surgical environment, and not merely theintelligent instrument 235. Alternatively, if an unidentifiedintelligent instrument is being used, the smoke evacuation system maydetermine that the device may be used in a universally safe operatingmode.

Energizing a status circuit, as noted above, that allows the smokeevacuation module 226 to query/poll other components may also providefor proprietary identification, authentication, and status text stringsfor the queried/polled components. This allows for a controlledidentification of the smoke evacuation module 226 and sub-components ofthe smoke evacuation module 226 in order to keep mimicking devices fromfooling the security device. For example, an example attempt at foolingthe security device is by building a “skimmer” to make uniqueconnections. In order to prevent the system from being fooled, anoperation may be performed to authenticate each component. Eachcomponent attached to the smoke evacuation system may be authenticatedbased on stored data, security encryption, authentication, parameters,or some combination thereof. The data stored may include anidentification number or another identifier, a product name, and aproduct type, a unique device identifier, a company trademark, a serialnumber and/or other manufacturing data, configuration parameters, usageinformation, features enabled or disabled, or an algorithm/instructionon how to use the attached component.

In the example shown in FIG. 23, the third segment 57106 may include amotor control circuit 57116 and a motor 57118. The motor control circuit57116 and/or motor 57118 may be coupled to or in signal communicationwith the main processor 57108 and/or the safety processor 57110. Themain processor 57108 may direct the motor control circuit 57116 toreduce or increase the speed of the motor 57118. In an alternateexample, the motor control circuit 57116 and the motor 57118 may becoupled to or in signal communication with the safety processor 57110.The motor 57118 may be coupled to a pump in the smoke evacuation module226 (see FIGS. 4 and 6-19), and operation of the motor 57118 may causethe pump to function. Specifically, in an example, the motor 57118 mayoperate at two different states. The first state may be when the motor57118 is activated by a user. In this first state the motor 57118 mayrun at a higher rate than in the second state. In the second state, themotor 57118, the motor control circuit 57116, the main processor 57108,or the safety processor 57110 may sense a lack of user activity or mayreceive an instruction from the main processor 57108, the safetyprocessor 57110, the surgical hub 204, the cloud 206, or another modulelocated within the surgical hub 206 (e.g., processor module 232) to slowthe rate of operation of the motor 57118.

The number of different states the motor 57118 may operate at is notlimited to two. The motor 57118 may change or choose its state ofoperation based on various measured values of parameters. In anotheraspect, the motor 57118 may determine or set its operating state basedon user activity levels falling within, above, or below specificthresholds. Further, these thresholds may relate to or interrelate withthresholds of other modules or components of the smoke evacuation module226.

In an alternate example, the motor 57118 may optionally have a modecalled sleep mode. In this example, sleep mode may be activated, or themotor 57118 may be shut down into a sleep mode (quite mode, or low powermode), when not used for a predetermined amount of time. The thresholdamount of time of inactivity prior to entering into sleep mode may varydepending on a number of factors, including the type of surgicalprocedure, the specific surgeon performing the procedure, or otherfactors. Therefore, the predetermined amount of time may be preset, butmay be easily adjusted. For example, the threshold from switching fromthe example active state to the sleep mode state may be ten minutes. Inthis example, if an intelligent instrument 235 is not used by a surgeonin more than ten minutes, the motor control circuit 57116 or motor 57118may receive an instruction to enter into sleep mode. In an alternateexample, if the intelligent instrument 235 is not used by the surgeon inmore than ten minutes, the intelligent instrument 235 may automaticallyactivate a sleep mode by slowing the motor 57118 to the sleep modestate. Further, when the smoke evacuation module 226 or intelligentinstrument 235 is used again or senses user interaction, the smokeevacuation module 226 may undergo a wakeup sequence to re-energize thesegmented circuit 57100. This wakeup sequence may be the same as thestart-up sequence used to energize the segmented circuit 57100 whilechecking for errors or faults. Alternatively, the wake up sequence maybe an abbreviated version of the start-up sequence to quicklyre-energize the segmented circuit 57100 when user interaction is sensed.

The example shown in FIG. 24 discloses a method 57200 of operating acontrol circuit portion of the smoke evacuation module 226 so as toenergize the segmented control circuit 57100 in stages, in accordancewith at least one aspect of the present disclosure. This way variousportions of the control circuit will be able to perform safety checksprior to energizing subsequent segments, providing a safe electricalstartup circuit method. Although the example method 57200 is describedwith reference to the flowchart illustrated in FIG. 24, it will beappreciated that many other methods of performing the acts associatedwith the method may be used. For example, the order of some of theblocks may be changed, certain blocks may be combined with other blocks,and some of the blocks described are optional.

According to the method 57200, the control circuit 57100 first activates57202 a first segment 57102. For example, as depicted previously in FIG.23, a first segment 57102 may include a main processor 57108 and asafety processor 57110. In an alternate example, other components alsomay be included in the first segment 57102, or the first segment 57102may not include a main processor 57108 and/or a safety processor 57110.

Next, the first segment 57102 performs a first function 57204. Thisfirst function, for example, may be related to verifying the safety ofthe control circuit 57100 and/or smoke evacuation module 226. Forexample, the main processor 57108 or the safety processor 57110 maycheck each segment or the components of the segments for short circuitsand other errors prior to engaging the high power portions of thesegmented control circuit 57100. The main processor 57108 and/or thesafety processor 57110 may perform safety checks on each component oreach segment to determine they are properly functioning. Further, inanother example, the main processor 57108 or the safety processor 57110may perform a verification function to ensure components in the smokeevacuation module 226 are the correct components. For example, the mainprocessor 57108 or the safety processor 57110 may include a TrustedPlatform Module (TPM), or the TPM may be a separate component in thesegmented control circuit 57100, for ensuring components of the smokeevacuator system 56100, 56300 are the correct components. Thisverification may be done in a variety of ways. For example, one examplemethod is to have stored in the TPM a key for each component or segment.If the connected components are compared and the key for each componentor segment is not found within the TPM, the smoke evacuation module 226may not enable or power those modules. In a further example, the keydiscussed may incorporate encryption or, alternatively, may requireauthentication by a component of the smoke evacuation module 226, suchas the main processor 57108 or the safety processor 57110.

Further, for example, the main processor 57108 and/or the safetyprocessor 57110 may include switching logic stored in memory thatprevents the segmented control circuit 57100 from activating portions ofthe circuit if specific safety conditions are not met. For example,there may exist a variety of conditions stored within the safetyprocessor 57118 affiliated with a logic switch or a plurality of logicswitches. For example, if a protection housing is not fully closed, if afilter module is not fully or properly inserted, if a fluid reservoir isnot fully or properly inserted, if a hosing is not properly or fullyinserted, and if a fluid reservoir is not adequately full, a logicswitch may be triggered and an affiliated portion of the segmentedcontrol circuit 57100 or smoke evacuation module 226 may not beactivated.

In an alternate example, there may exist a separate enclosure circuit toensure the housing is fully and properly closed before allowing thesmoke evacuation module 226, or one of the various segments, to beactivated or operated. For example, if the housing is not fully closed,the circuit may not be complete. Therefore, the remaining segments orcomponents of the segmented control circuit 57100 may not be activated.This enclosure circuit concept may be used in a tamper circuit toprevent unauthorized servicing. For example, a tamper circuit mayinclude a confirmation circuit. If a housing is opened that should notbe opened, the confirmation circuit may be permanently broken eitherelectrically or mechanically. This breakable confirmation circuit has aninner connection strip which may bridge two rigidly fixed electricalconnection blocks, one block may be located on a shell of the enclosureand the other block may be located on the base frame of the enclosure.The inner connection my have a rigid insertable electrical connectorthat may lock into the respective connection blocks with a latchingfeature on each of the shell and the base frame. When broken, it may beevident that the housing has been opened or tampered with. Once broken,the electrical connectors may be easily released and replaced once thehousing is opened in order for replacement. In an alternate aspect, theblocks and latching features may be located at different positions, andeach segment may include separate blocks and latching features. Forexample, the first segment 57102, the second segment 57104, and thethird segment 57106 may each have a separate confirmation circuit. Ifthe first segment 57102 is tampered with or opened, the confirmationcircuit may be broken as the rigid inner connection strip may be broken,and therefore can be identified as being tampered with and/or theconfirmation circuit may be replaced. By having separate confirmationcircuits, it may be easily detectable if any of the various segments orcomponents of the segmented control circuit 57100 has been tamperedwith.

Alternatively, an enclosure circuit may be used as a segmented securitydevice. For example, if a portion of the system requires servicing, anenclosure circuit may enable a portion of the system to be opened andserviced, but prevent use of the segmented control circuit 57100 orsmoke evacuation module 226 after an unauthorized, separate portion ofthe segmented control circuit 57100 may have been opened, dismantled, ormodified. For example, if the smoke evacuation system's 226 segmentedcontrol circuit 57100 should be serviced, but only the display circuit57114 needs servicing, there may be no reason for a service technicianor other personnel to service the third segment 57106 or the firstsegment 57102. Therefore, the third segment 57106 and the first segment57102 may include separate enclosure circuits containing single usefuses or other mechanical/electromechanical devices, or digital versionsof the like. Once the third segment 57106 and the first segment 57102are opened, modified, or dismantled, the fuses may blow, allowing nopower to reach the third segment 57106 and the first segment 57102.

If an error, short circuit, fault, or other issue is detected, thesegmented control circuit 57100 may be capable of running at least onesegment of the segmented control circuit 57100, while not running othersegments. In order to ensure safety of the segmented control circuit57100, portions of the segmented control circuit 57100, and theirconnections therebetween, may be physically switched, fused, orbreakered allowing the switches, fuses, and breakers to trip and preventenergizing if an unsafe condition exists. Any suitable mechanical,electromechanical, or solid state switches may be employed to implementthe plurality of switches. For example, there may exist a single-usefuse, reset-able fuse, or a solid state switching device existingbetween the main processor 57108 and the motor control circuit 57116.Generally, a fuse is an electrical safety device that operates toprovide overcurrent protection of an electrical circuit. It may includea metal wire or strip that melts when too much current flows through it,thereby interrupting the current. Generally, a resettable fuse is apolymeric positive temperature coefficient (PPTC) device that is apassive electronic component used to protect against overcurrent faultsin electronic circuits. The device may be also known as a polyfuse orpolyswitch. Generally, a solid-state switch operates under the influenceof a magnetic field such as Hall-effect devices, magneto-resistive (MR)devices, giant magneto-resistive (GMR) devices, and magnetometers, amongothers. In other implementations, the switches may be solid-stateswitches that operate under the influence of light, such as opticalsensors, infrared sensors, and ultraviolet sensors, among others. Still,the switches may be solid-state devices such as transistors (e.g., FET,Junction-FET, metal-oxide semiconductor-FET (MOSFET), bipolar, and thelike). Other switches may include wireless switches, ultrasonicswitches, accelerometers, and inertial sensors, among others.

Next, a second segment may be activated 57206. For example, the secondsegment 57104, including the sensing circuit 57112 and the displaycircuit 57114, may be energized. Next, a third segment may be activated57208. For example, the third segment 57106, including the motor controlcircuit 57116 and the motor 57118, may be energized. Although thisexample aspect discloses activating the first segment 57102 before thesecond, and the second segment 57104 before the third segment 57106, theorder of segment activation may be modified if deemed appropriate.Further, in an alternate example, a variety of error checks,verifications, etc. may be performed between energizing the secondsegment 57104 and the third segment 57106.

The reader will readily appreciate that various surgical evacuationsystems and components described herein can be incorporated into acomputer-implemented interactive surgical system, a surgical hub, and/ora robotic system. For example, a surgical evacuation system cancommunicate data to a surgical hub, a robotic system, and/or acomputer-implanted interactive surgical system and/or can receive datafrom a surgical hub, robotic system, and/or a computer-implementedinteractive surgical system. Various examples of computer-implementedinteractive surgical systems, robotic systems, and surgical hubs arefurther described below.

Computer-Implemented Interactive Surgical System

Referring to FIG. 25, a computer-implemented interactive surgical system100 includes one or more surgical systems 102 and a cloud-based system(e.g., the cloud 104 that may include a remote server 113 coupled to astorage device 105). Each surgical system 102 includes at least onesurgical hub 106 in communication with the cloud 104 that may include aremote server 113. In one example, as illustrated in FIG. 25, thesurgical system 102 includes a visualization system 108, a roboticsystem 110, and a handheld intelligent surgical instrument 112, whichare configured to communicate with one another and/or the hub 106. Insome aspects, a surgical system 102 may include an M number of hubs 106,an N number of visualization systems 108, an O number of robotic systems110, and a P number of handheld intelligent surgical instruments 112,where M, N, O, and P are integers greater than or equal to one.

FIG. 27 depicts an example of a surgical system 102 being used toperform a surgical procedure on a patient who is lying down on anoperating table 114 in a surgical operating room 116. A robotic system110 is used in the surgical procedure as a part of the surgical system102. The robotic system 110 includes a surgeon's console 118, a patientside cart 120 (surgical robot), and a surgical robotic hub 122. Thepatient side cart 120 can manipulate at least one removably coupledsurgical tool 117 through a minimally invasive incision in the body ofthe patient while the surgeon views the surgical site through thesurgeon's console 118. An image of the surgical site can be obtained bya medical imaging device 124, which can be manipulated by the patientside cart 120 to orient the imaging device 124. The robotic hub 122 canbe used to process the images of the surgical site for subsequentdisplay to the surgeon through the surgeon's console 118.

Other types of robotic systems can be readily adapted for use with thesurgical system 102. Various examples of robotic systems and surgicaltools that are suitable for use with the present disclosure aredescribed in U.S. Provisional Patent Application Ser. No. 62/611,339,titled ROBOT ASSISTED SURGICAL PLATFORM, filed Dec. 28, 2017, thedisclosure of which is herein incorporated by reference in its entirety.

Various examples of cloud-based analytics that are performed by thecloud 104, and are suitable for use with the present disclosure, aredescribed in U.S. Provisional Patent Application Ser. No. 62/611,340,titled CLOUD-BASED MEDICAL ANALYTICS, filed Dec. 28, 2017, thedisclosure of which is herein incorporated by reference in its entirety.

In various aspects, the imaging device 124 includes at least one imagesensor and one or more optical components. Suitable image sensorsinclude, but are not limited to, Charge-Coupled Device (CCD) sensors andComplementary Metal-Oxide Semiconductor (CMOS) sensors.

The optical components of the imaging device 124 may include one or moreillumination sources and/or one or more lenses. The one or moreillumination sources may be directed to illuminate portions of thesurgical field. The one or more image sensors may receive lightreflected or refracted from the surgical field, including lightreflected or refracted from tissue and/or surgical instruments.

The one or more illumination sources may be configured to radiateelectromagnetic energy in the visible spectrum as well as the invisiblespectrum. The visible spectrum, sometimes referred to as the opticalspectrum or luminous spectrum, is that portion of the electromagneticspectrum that is visible to (i.e., can be detected by) the human eye andmay be referred to as visible light or simply light. A typical human eyewill respond to wavelengths in air that are from about 380 nm to about750 nm.

The invisible spectrum (i.e., the non-luminous spectrum) is that portionof the electromagnetic spectrum that lies below and above the visiblespectrum (i.e., wavelengths below about 380 nm and above about 750 nm).The invisible spectrum is not detectable by the human eye. Wavelengthsgreater than about 750 nm are longer than the red visible spectrum, andthey become invisible infrared (IR), microwave, and radioelectromagnetic radiation. Wavelengths less than about 380 nm areshorter than the violet spectrum, and they become invisible ultraviolet,x-ray, and gamma ray electromagnetic radiation.

In various aspects, the imaging device 124 is configured for use in aminimally invasive procedure. Examples of imaging devices suitable foruse with the present disclosure include, but not limited to, anarthroscope, angioscope, bronchoscope, choledochoscope, colonoscope,cytoscope, duodenoscope, enteroscope, esophagogastro-duodenoscope(gastroscope), endoscope, laryngoscope, nasopharyngo-neproscope,sigmoidoscope, thoracoscope, and ureteroscope.

In one aspect, the imaging device employs multi-spectrum monitoring todiscriminate topography and underlying structures. A multi-spectralimage is one that captures image data within specific wavelength rangesacross the electromagnetic spectrum. The wavelengths may be separated byfilters or by the use of instruments that are sensitive to particularwavelengths, including light from frequencies beyond the visible lightrange, e.g., IR and ultraviolet. Spectral imaging can allow extractionof additional information the human eye fails to capture with itsreceptors for red, green, and blue. The use of multi-spectral imaging isdescribed in greater detail under the heading “Advanced ImagingAcquisition Module” in U.S. Provisional Patent Application Ser. No.62/611,341, titled INTERACTIVE SURGICAL PLATFORM, filed Dec. 28, 2017,the disclosure of which is herein incorporated by reference in itsentirety. Multi-spectrum monitoring can be a useful tool in relocating asurgical field after a surgical task is completed to perform one or moreof the previously described tests on the treated tissue.

It is axiomatic that strict sterilization of the operating room andsurgical equipment is required during any surgery. The strict hygieneand sterilization conditions required in a “surgical theater,” i.e., anoperating or treatment room, necessitate the highest possible sterilityof all medical devices and equipment. Part of that sterilization processis the need to sterilize anything that comes in contact with the patientor penetrates the sterile field, including the imaging device 124 andits attachments and components. It will be appreciated that the sterilefield may be considered a specified area, such as within a tray or on asterile towel, that is considered free of microorganisms, or the sterilefield may be considered an area, immediately around a patient, who hasbeen prepared for a surgical procedure. The sterile field may includethe scrubbed team members, who are properly attired, and all furnitureand fixtures in the area.

In various aspects, the visualization system 108 includes one or moreimaging sensors, one or more image processing units, one or more storagearrays, and one or more displays that are strategically arranged withrespect to the sterile field, as illustrated in FIG. 26. In one aspect,the visualization system 108 includes an interface for HL7, PACS, andEMR. Various components of the visualization system 108 are describedunder the heading “Advanced Imaging Acquisition Module” in U.S.Provisional Patent Application Ser. No. 62/611,341, titled INTERACTIVESURGICAL PLATFORM, filed Dec. 28, 2017, the disclosure of which isherein incorporated by reference in its entirety.

As illustrated in FIG. 26, a primary display 119 is positioned in thesterile field to be visible to an operator at the operating table 114.In addition, a visualization tower 111 is positioned outside the sterilefield. The visualization tower 111 includes a first non-sterile display107 and a second non-sterile display 109, which face away from eachother. The visualization system 108, guided by the hub 106, isconfigured to utilize the displays 107, 109, and 119 to coordinateinformation flow to operators inside and outside the sterile field. Forexample, the hub 106 may cause the visualization system 108 to display asnap-shot of a surgical site, as recorded by an imaging device 124, on anon-sterile display 107 or 109, while maintaining a live feed of thesurgical site on the primary display 119. The snap-shot on thenon-sterile display 107 or 109 can permit a non-sterile operator toperform a diagnostic step relevant to the surgical procedure, forexample.

In one aspect, the hub 106 is also configured to route a diagnosticinput or feedback entered by a non-sterile operator at the visualizationtower 111 to the primary display 119 within the sterile field, where itcan be viewed by a sterile operator at the operating table. In oneexample, the input can be in the form of a modification to the snap-shotdisplayed on the non-sterile display 107 or 109, which can be routed tothe primary display 119 by the hub 106.

Referring to FIG. 26, a surgical instrument 112 is being used in thesurgical procedure as part of the surgical system 102. The hub 106 isalso configured to coordinate information flow to a display of thesurgical instrument 112. For example, in U.S. Provisional PatentApplication Ser. No. 62/611,341, titled INTERACTIVE SURGICAL PLATFORM,filed Dec. 28, 2017, the disclosure of which is herein incorporated byreference in its entirety. A diagnostic input or feedback entered by anon-sterile operator at the visualization tower 111 can be routed by thehub 106 to the surgical instrument display 115 within the sterile field,where it can be viewed by the operator of the surgical instrument 112.Example surgical instruments that are suitable for use with the surgicalsystem 102 are described under the heading “Surgical InstrumentHardware” and in U.S. Provisional Patent Application Ser. No.62/611,341, titled INTERACTIVE SURGICAL PLATFORM, filed Dec. 28, 2017,the disclosure of which is herein incorporated by reference in itsentirety, for example.

Referring now to FIG. 27, a hub 106 is depicted in communication with avisualization system 108, a robotic system 110, and a handheldintelligent surgical instrument 112. The hub 106 includes a hub display135, an imaging module 138, a generator module 140, a communicationmodule 130, a processor module 132, and a storage array 134. In certainaspects, as illustrated in FIG. 27, the hub 106 further includes a smokeevacuation module 126 and/or a suction/irrigation module 128.

During a surgical procedure, energy application to tissue, for sealingand/or cutting, is generally associated with smoke evacuation, suctionof excess fluid, and/or irrigation of the tissue. Fluid, power, and/ordata lines from different sources are often entangled during thesurgical procedure. Valuable time can be lost addressing this issueduring a surgical procedure. Detangling the lines may necessitatedisconnecting the lines from their respective modules, which may requireresetting the modules. The hub modular enclosure 136 offers a unifiedenvironment for managing the power, data, and fluid lines, which reducesthe frequency of entanglement between such lines.

Aspects of the present disclosure present a surgical hub for use in asurgical procedure that involves energy application to tissue at asurgical site. The surgical hub includes a hub enclosure and a combogenerator module slidably receivable in a docking station of the hubenclosure. The docking station includes data and power contacts. Thecombo generator module includes two or more of an ultrasonic energygenerator component, a bipolar RF energy generator component, and amonopolar RF energy generator component that are housed in a singleunit. In one aspect, the combo generator module also includes a smokeevacuation component, at least one energy delivery cable for connectingthe combo generator module to a surgical instrument, at least one smokeevacuation component configured to evacuate smoke, fluid, and/orparticulates generated by the application of therapeutic energy to thetissue, and a fluid line extending from the remote surgical site to thesmoke evacuation component.

In one aspect, the fluid line is a first fluid line and a second fluidline extends from the remote surgical site to a suction and irrigationmodule slidably received in the hub enclosure. In one aspect, the hubenclosure comprises a fluid interface.

Certain surgical procedures may require the application of more than oneenergy type to the tissue. One energy type may be more beneficial forcutting the tissue, while another different energy type may be morebeneficial for sealing the tissue. For example, a bipolar generator canbe used to seal the tissue while an ultrasonic generator can be used tocut the sealed tissue. Aspects of the present disclosure present asolution where a hub modular enclosure 136 is configured to accommodatedifferent generators, and facilitate an interactive communicationtherebetween. One of the advantages of the hub modular enclosure 136 isenabling the quick removal and/or replacement of various modules.

Aspects of the present disclosure present a modular surgical enclosurefor use in a surgical procedure that involves energy application totissue. The modular surgical enclosure includes a first energy-generatormodule, configured to generate a first energy for application to thetissue, and a first docking station comprising a first docking port thatincludes first data and power contacts, wherein the firstenergy-generator module is slidably movable into an electricalengagement with the power and data contacts and wherein the firstenergy-generator module is slidably movable out of the electricalengagement with the first power and data contacts.

Further to the above, the modular surgical enclosure also includes asecond energy-generator module configured to generate a second energy,different than the first energy, for application to the tissue, and asecond docking station comprising a second docking port that includessecond data and power contacts, wherein the second energy-generatormodule is slidably movable into an electrical engagement with the powerand data contacts, and wherein the second energy-generator module isslidably movable out of the electrical engagement with the second powerand data contacts.

In addition, the modular surgical enclosure also includes acommunication bus between the first docking port and the second dockingport, configured to facilitate communication between the firstenergy-generator module and the second energy-generator module.

Referring to FIGS. 3-7, aspects of the present disclosure are presentedfor a hub modular enclosure 136 that allows the modular integration of agenerator module 140, a smoke evacuation module 126, and asuction/irrigation module 128. The hub modular enclosure 136 furtherfacilitates interactive communication between the modules 140, 126, 128.As illustrated in FIG. 29, the generator module 140 can be a generatormodule with integrated monopolar, bipolar, and ultrasonic componentssupported in a single housing unit 139 slidably insertable into the hubmodular enclosure 136. As illustrated in FIG. 29, the generator module140 can be configured to connect to a monopolar device 146, a bipolardevice 147, and an ultrasonic device 148. Alternatively, the generatormodule 140 may comprise a series of monopolar, bipolar, and/orultrasonic generator modules that interact through the hub modularenclosure 136. The hub modular enclosure 136 can be configured tofacilitate the insertion of multiple generators and interactivecommunication between the generators docked into the hub modularenclosure 136 so that the generators would act as a single generator.

In one aspect, the hub modular enclosure 136 comprises a modular powerand communication backplane 149 with external and wireless communicationheaders to enable the removable attachment of the modules 140, 126, 128and interactive communication therebetween.

In one aspect, the hub modular enclosure 136 includes docking stations,or drawers, 151, herein also referred to as drawers, which areconfigured to slidably receive the modules 140, 126, 128. FIG. 28illustrates a partial perspective view of a surgical hub enclosure 136,and a combo generator module 145 slidably receivable in a dockingstation 151 of the surgical hub enclosure 136. A docking port 152 withpower and data contacts on a rear side of the combo generator module 145is configured to engage a corresponding docking port 150 with power anddata contacts of a corresponding docking station 151 of the hub modularenclosure 136 as the combo generator module 145 is slid into positionwithin the corresponding docking station 151 of the hub module enclosure136. In one aspect, the combo generator module 145 includes a bipolar,ultrasonic, and monopolar module and a smoke evacuation moduleintegrated together into a single housing unit 139, as illustrated inFIG. 29.

In various aspects, the smoke evacuation module 126 includes a fluidline 154 that conveys captured/collected smoke and/or fluid away from asurgical site and to, for example, the smoke evacuation module 126.Vacuum suction originating from the smoke evacuation module 126 can drawthe smoke into an opening of a utility conduit at the surgical site. Theutility conduit, coupled to the fluid line, can be in the form of aflexible tube terminating at the smoke evacuation module 126. Theutility conduit and the fluid line define a fluid path extending towardthe smoke evacuation module 126 that is received in the hub enclosure136.

In various aspects, the suction/irrigation module 128 is coupled to asurgical tool comprising an aspiration fluid line and a suction fluidline. In one example, the aspiration and suction fluid lines are in theform of flexible tubes extending from the surgical site toward thesuction/irrigation module 128. One or more drive systems can beconfigured to cause irrigation and aspiration of fluids to and from thesurgical site.

In one aspect, the surgical tool includes a shaft having an end effectorat a distal end thereof and at least one energy treatment associatedwith the end effector, an aspiration tube, and an irrigation tube. Theaspiration tube can have an inlet port at a distal end thereof and theaspiration tube extends through the shaft. Similarly, an irrigation tubecan extend through the shaft and can have an inlet port in proximity tothe energy deliver implement. The energy deliver implement is configuredto deliver ultrasonic and/or RF energy to the surgical site and iscoupled to the generator module 140 by a cable extending initiallythrough the shaft.

The irrigation tube can be in fluid communication with a fluid source,and the aspiration tube can be in fluid communication with a vacuumsource. The fluid source and/or the vacuum source can be housed in thesuction/irrigation module 128. In one example, the fluid source and/orthe vacuum source can be housed in the hub enclosure 136 separately fromthe suction/irrigation module 128. In such example, a fluid interfacecan be configured to connect the suction/irrigation module 128 to thefluid source and/or the vacuum source.

In one aspect, the modules 140, 126, 128 and/or their correspondingdocking stations on the hub modular enclosure 136 may include alignmentfeatures that are configured to align the docking ports of the modulesinto engagement with their counterparts in the docking stations of thehub modular enclosure 136. For example, as illustrated in FIG. 28, thecombo generator module 145 includes side brackets 155 that areconfigured to slidably engage with corresponding brackets 156 of thecorresponding docking station 151 of the hub modular enclosure 136. Thebrackets cooperate to guide the docking port contacts of the combogenerator module 145 into an electrical engagement with the docking portcontacts of the hub modular enclosure 136.

In some aspects, the drawers 151 of the hub modular enclosure 136 arethe same, or substantially the same size, and the modules are adjustedin size to be received in the drawers 151. For example, the sidebrackets 155 and/or 156 can be larger or smaller depending on the sizeof the module. In other aspects, the drawers 151 are different in sizeand are each designed to accommodate a particular module.

Furthermore, the contacts of a particular module can be keyed forengagement with the contacts of a particular drawer to avoid inserting amodule into a drawer with mismatching contacts.

As illustrated in FIG. 28, the docking port 150 of one drawer 151 can becoupled to the docking port 150 of another drawer 151 through acommunications link 157 to facilitate an interactive communicationbetween the modules housed in the hub modular enclosure 136. The dockingports 150 of the hub modular enclosure 136 may alternatively, oradditionally, facilitate a wireless interactive communication betweenthe modules housed in the hub modular enclosure 136. Any suitablewireless communication can be employed, such as for example AirTitan-Bluetooth.

FIG. 30 illustrates individual power bus attachments for a plurality oflateral docking ports of a lateral modular housing 160 configured toreceive a plurality of modules of a surgical hub 206. The lateralmodular housing 160 is configured to laterally receive and interconnectthe modules 161. The modules 161 are slidably inserted into dockingstations 162 of lateral modular housing 160, which includes a backplanefor interconnecting the modules 161. As illustrated in FIG. 30, themodules 161 are arranged laterally in the lateral modular housing 160.Alternatively, the modules 161 may be arranged vertically in a lateralmodular housing.

FIG. 31 illustrates a vertical modular housing 164 configured to receivea plurality of modules 165 of the surgical hub 106. The modules 165 areslidably inserted into docking stations, or drawers, 167 of verticalmodular housing 164, which includes a backplane for interconnecting themodules 165. Although the drawers 167 of the vertical modular housing164 are arranged vertically, in certain instances, a vertical modularhousing 164 may include drawers that are arranged laterally.Furthermore, the modules 165 may interact with one another through thedocking ports of the vertical modular housing 164. In the example ofFIG. 31, a display 177 is provided for displaying data relevant to theoperation of the modules 165. In addition, the vertical modular housing164 includes a master module 178 housing a plurality of sub-modules thatare slidably received in the master module 178.

In various aspects, the imaging module 138 comprises an integrated videoprocessor and a modular light source and is adapted for use with variousimaging devices. In one aspect, the imaging device is comprised of amodular housing that can be assembled with a light source module and acamera module. The housing can be a disposable housing. In at least oneexample, the disposable housing is removably coupled to a reusablecontroller, a light source module, and a camera module. The light sourcemodule and/or the camera module can be selectively chosen depending onthe type of surgical procedure. In one aspect, the camera modulecomprises a CCD sensor. In another aspect, the camera module comprises aCMOS sensor. In another aspect, the camera module is configured forscanned beam imaging. Likewise, the light source module can beconfigured to deliver a white light or a different light, depending onthe surgical procedure.

During a surgical procedure, removing a surgical device from thesurgical field and replacing it with another surgical device thatincludes a different camera or a different light source can beinefficient. Temporarily losing sight of the surgical field may lead toundesirable consequences. The module imaging device of the presentdisclosure is configured to permit the replacement of a light sourcemodule or a camera module midstream during a surgical procedure, withouthaving to remove the imaging device from the surgical field.

In one aspect, the imaging device comprises a tubular housing thatincludes a plurality of channels. A first channel is configured toslidably receive the camera module, which can be configured for asnap-fit engagement with the first channel. A second channel isconfigured to slidably receive the light source module, which can beconfigured for a snap-fit engagement with the second channel. In anotherexample, the camera module and/or the light source module can be rotatedinto a final position within their respective channels. A threadedengagement can be employed in lieu of the snap-fit engagement.

In various examples, multiple imaging devices are placed at differentpositions in the surgical field to provide multiple views. The imagingmodule 138 can be configured to switch between the imaging devices toprovide an optimal view. In various aspects, the imaging module 138 canbe configured to integrate the images from the different imaging device.

Various image processors and imaging devices suitable for use with thepresent disclosure are described in U.S. Pat. No. 7,995,045, titledCOMBINED SBI AND CONVENTIONAL IMAGE PROCESSOR, which issued on Aug. 9,2011, which is herein incorporated by reference in its entirety. Inaddition, U.S. Pat. No. 7,982,776, titled SBI MOTION ARTIFACT REMOVALAPPARATUS AND METHOD, which issued on Jul. 19, 2011, which is hereinincorporated by reference in its entirety, describes various systems forremoving motion artifacts from image data. Such systems can beintegrated with the imaging module 138. Furthermore, U.S. PatentApplication Publication No. 2011/0306840, titled CONTROLLABLE MAGNETICSOURCE TO FIXTURE INTRACORPOREAL APPARATUS, which published on Dec. 15,2011, and U.S. Patent Application Publication No. 2014/0243597, titledSYSTEM FOR PERFORMING A MINIMALLY INVASIVE SURGICAL PROCEDURE, whichpublished on Aug. 28, 2014, each of which is herein incorporated byreference in its entirety.

FIG. 32 illustrates a surgical data network 201 comprising a modularcommunication hub 203 configured to connect modular devices located inone or more operating theaters of a healthcare facility, or any room ina healthcare facility specially equipped for surgical operations, to acloud-based system (e.g., the cloud 204 that may include a remote server213 coupled to a storage device 205). In one aspect, the modularcommunication hub 203 comprises a network hub 207 and/or a networkswitch 209 in communication with a network router. The modularcommunication hub 203 also can be coupled to a local computer system 210to provide local computer processing and data manipulation. The surgicaldata network 201 may be configured as passive, intelligent, orswitching. A passive surgical data network serves as a conduit for thedata, enabling it to go from one device (or segment) to another and tothe cloud computing resources. An intelligent surgical data networkincludes additional features to enable the traffic passing through thesurgical data network to be monitored and to configure each port in thenetwork hub 207 or network switch 209. An intelligent surgical datanetwork may be referred to as a manageable hub or switch. A switchinghub reads the destination address of each packet and then forwards thepacket to the correct port.

Modular devices 1 a-1 n located in the operating theater may be coupledto the modular communication hub 203. The network hub 207 and/or thenetwork switch 209 may be coupled to a network router 211 to connect thedevices 1 a-1 n to the cloud 204 or the local computer system 210. Dataassociated with the devices 1 a-1 n may be transferred to cloud-basedcomputers via the router for remote data processing and manipulation.Data associated with the devices 1 a-1 n may also be transferred to thelocal computer system 210 for local data processing and manipulation.Modular devices 2 a-2 m located in the same operating theater also maybe coupled to a network switch 209. The network switch 209 may becoupled to the network hub 207 and/or the network router 211 to connectto the devices 2 a-2 m to the cloud 204. Data associated with thedevices 2 a-2 n may be transferred to the cloud 204 via the networkrouter 211 for data processing and manipulation. Data associated withthe devices 2 a-2 m may also be transferred to the local computer system210 for local data processing and manipulation.

It will be appreciated that the surgical data network 201 may beexpanded by interconnecting multiple network hubs 207 and/or multiplenetwork switches 209 with multiple network routers 211. The modularcommunication hub 203 may be contained in a modular control towerconfigured to receive multiple devices 1 a-1 n/2 a-2 m. The localcomputer system 210 also may be contained in a modular control tower.The modular communication hub 203 is connected to a display 212 todisplay images obtained by some of the devices 1 a-1 n/2 a-2 m, forexample during surgical procedures. In various aspects, the devices 1a-1 n/2 a-2 m may include, for example, various modules such as animaging module 138 coupled to an endoscope, a generator module 140coupled to an energy-based surgical device, a smoke evacuation module126, a suction/irrigation module 128, a communication module 130, aprocessor module 132, a storage array 134, a surgical device coupled toa display, and/or a non-contact sensor module, among other modulardevices that may be connected to the modular communication hub 203 ofthe surgical data network 201.

In one aspect, the surgical data network 201 may comprise a combinationof network hub(s), network switch(es), and network router(s) connectingthe devices 1 a-1 n/2 a-2 m to the cloud. Any one of or all of thedevices 1 a-1 n/2 a-2 m coupled to the network hub or network switch maycollect data in real time and transfer the data to cloud computers fordata processing and manipulation. It will be appreciated that cloudcomputing relies on sharing computing resources rather than having localservers or personal devices to handle software applications. The word“cloud” may be used as a metaphor for “the Internet,” although the termis not limited as such. Accordingly, the term “cloud computing” may beused herein to refer to “a type of Internet-based computing,” wheredifferent services—such as servers, storage, and applications—aredelivered to the modular communication hub 203 and/or computer system210 located in the surgical theater (e.g., a fixed, mobile, temporary,or field operating room or space) and to devices connected to themodular communication hub 203 and/or computer system 210 through theInternet. The cloud infrastructure may be maintained by a cloud serviceprovider. In this context, the cloud service provider may be the entitythat coordinates the usage and control of the devices 1 a-1 n/2 a-2 mlocated in one or more operating theaters. The cloud computing servicescan perform a large number of calculations based on the data gathered bysmart surgical instruments, robots, and other computerized deviceslocated in the operating theater. The hub hardware enables multipledevices or connections to be connected to a computer that communicateswith the cloud computing resources and storage.

Applying cloud computer data processing techniques on the data collectedby the devices 1 a-1 n/2 a-2 m, the surgical data network providesimproved surgical outcomes, reduced costs, and improved patientsatisfaction. At least some of the devices 1 a-1 n/2 a-2 m may beemployed to view tissue states to assess leaks or perfusion of sealedtissue after a tissue sealing and cutting procedure. At least some ofthe devices 1 a-1 n/2 a-2 m may be employed to identify pathology, suchas the effects of diseases, using the cloud-based computing to examinedata including images of samples of body tissue for diagnostic purposes.This includes localization and margin confirmation of tissue andphenotypes. At least some of the devices 1 a-1 n/2 a-2 m may be employedto identify anatomical structures of the body using a variety of sensorsintegrated with imaging devices and techniques such as overlaying imagescaptured by multiple imaging devices. The data gathered by the devices 1a-1 n/2 a-2 m, including image data, may be transferred to the cloud 204or the local computer system 210 or both for data processing andmanipulation including image processing and manipulation. The data maybe analyzed to improve surgical procedure outcomes by determining iffurther treatment, such as the application of endoscopic intervention,emerging technologies, a targeted radiation, targeted intervention, andprecise robotics to tissue-specific sites and conditions, may bepursued. Such data analysis may further employ outcome analyticsprocessing, and using standardized approaches may provide beneficialfeedback to either confirm surgical treatments and the behavior of thesurgeon or suggest modifications to surgical treatments and the behaviorof the surgeon.

In one implementation, the operating theater devices 1 a-1 n may beconnected to the modular communication hub 203 over a wired channel or awireless channel depending on the configuration of the devices 1 a-1 nto a network hub. The network hub 207 may be implemented, in one aspect,as a local network broadcast device that works on the physical layer ofthe Open System Interconnection (OSI) model. The network hub providesconnectivity to the devices 1 a-1 n located in the same operatingtheater network. The network hub 207 collects data in the form ofpackets and sends them to the router in half duplex mode. The networkhub 207 does not store any media access control/internet protocol(MAC/IP) to transfer the device data. Only one of the devices 1 a-1 ncan send data at a time through the network hub 207. The network hub 207has no routing tables or intelligence regarding where to sendinformation and broadcasts all network data across each connection andto a remote server 213 (FIG. 33) over the cloud 204. The network hub 207can detect basic network errors such as collisions, but having allinformation broadcast to multiple ports can be a security risk and causebottlenecks.

In another implementation, the operating theater devices 2 a-2 m may beconnected to a network switch 209 over a wired channel or a wirelesschannel. The network switch 209 works in the data link layer of the OSImodel. The network switch 209 is a multicast device for connecting thedevices 2 a-2 m located in the same operating theater to the network.The network switch 209 sends data in the form of frames to the networkrouter 211 and works in full duplex mode. Multiple devices 2 a-2 m cansend data at the same time through the network switch 209. The networkswitch 209 stores and uses MAC addresses of the devices 2 a-2 m totransfer data.

The network hub 207 and/or the network switch 209 are coupled to thenetwork router 211 for connection to the cloud 204. The network router211 works in the network layer of the OSI model. The network router 211creates a route for transmitting data packets received from the networkhub 207 and/or network switch 211 to cloud-based computer resources forfurther processing and manipulation of the data collected by any one ofor all the devices 1 a-1 n/2 a-2 m. The network router 211 may beemployed to connect two or more different networks located in differentlocations, such as, for example, different operating theaters of thesame healthcare facility or different networks located in differentoperating theaters of different healthcare facilities. The networkrouter 211 sends data in the form of packets to the cloud 204 and worksin full duplex mode. Multiple devices can send data at the same time.The network router 211 uses IP addresses to transfer data.

In one example, the network hub 207 may be implemented as a USB hub,which allows multiple USB devices to be connected to a host computer.The USB hub may expand a single USB port into several tiers so thatthere are more ports available to connect devices to the host systemcomputer. The network hub 207 may include wired or wireless capabilitiesto receive information over a wired channel or a wireless channel. Inone aspect, a wireless USB short-range, high-bandwidth wireless radiocommunication protocol may be employed for communication between thedevices 1 a-1 n and devices 2 a-2 m located in the operating theater.

In other examples, the operating theater devices 1 a-1 n/2 a-2 m maycommunicate to the modular communication hub 203 via Bluetooth wirelesstechnology standard for exchanging data over short distances (usingshort-wavelength UHF radio waves in the ISM band from 2.4 to 2.485 GHz)from fixed and mobile devices and building personal area networks(PANs). In other aspects, the operating theater devices 1 a-1 n/2 a-2 mmay communicate to the modular communication hub 203 via a number ofwireless or wired communication standards or protocols, including butnot limited to Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family),IEEE 802.20, long-term evolution (LTE), and Ev-DO, HSPA+, HSDPA+,HSUPA+, EDGE, GSM, GPRS, CDMA, TDMA, DECT, and Ethernet derivativesthereof, as well as any other wireless and wired protocols that aredesignated as 3G, 4G, 5G, and beyond. The computing module may include aplurality of communication modules. For instance, a first communicationmodule may be dedicated to shorter-range wireless communications such asWi-Fi and Bluetooth, and a second communication module may be dedicatedto longer-range wireless communications such as GPS, EDGE, GPRS, CDMA,WiMAX, LTE, Ev-DO, and others.

The modular communication hub 203 may serve as a central connection forone or all of the operating theater devices 1 a-1 n/2 a-2 m and handlesa data type known as frames. Frames carry the data generated by thedevices 1 a-1 n/2 a-2 m. When a frame is received by the modularcommunication hub 203, it is amplified and transmitted to the networkrouter 211, which transfers the data to the cloud computing resources byusing a number of wireless or wired communication standards orprotocols, as described herein.

The modular communication hub 203 can be used as a standalone device orbe connected to compatible network hubs and network switches to form alarger network. The modular communication hub 203 is generally easy toinstall, configure, and maintain, making it a good option for networkingthe operating theater devices 1 a-1 n/2 a-2 m.

FIG. 33 illustrates a computer-implemented interactive surgical system200. The computer-implemented interactive surgical system 200 is similarin many respects to the computer-implemented interactive surgical system100. For example, the computer-implemented interactive surgical system200 includes one or more surgical systems 202, which are similar in manyrespects to the surgical systems 102. Each surgical system 202 includesat least one surgical hub 206 in communication with a cloud 204 that mayinclude a remote server 213. In one aspect, the computer-implementedinteractive surgical system 200 comprises a modular control tower 236connected to multiple operating theater devices such as, for example,intelligent surgical instruments, robots, and other computerized deviceslocated in the operating theater. As shown in FIG. 34, the modularcontrol tower 236 comprises a modular communication hub 203 coupled to acomputer system 210. As illustrated in the example of FIG. 33, themodular control tower 236 is coupled to an imaging module 238 that iscoupled to an endoscope 239, a generator module 240 that is coupled toan energy device 241, a smoke evacuator module 226, a suction/irrigationmodule 228, a communication module 230, a processor module 232, astorage array 234, a smart device/instrument 235 optionally coupled to adisplay 237, and a non-contact sensor module 242. The operating theaterdevices are coupled to cloud computing resources and data storage viathe modular control tower 236. A robot hub 222 also may be connected tothe modular control tower 236 and to the cloud computing resources. Thedevices/instruments 235, visualization systems 208, among others, may becoupled to the modular control tower 236 via wired or wirelesscommunication standards or protocols, as described herein. The modularcontrol tower 236 may be coupled to a hub display 215 (e.g., monitor,screen) to display and overlay images received from the imaging module,device/instrument display, and/or other visualization systems 208. Thehub display also may display data received from devices connected to themodular control tower in conjunction with images and overlaid images.

FIG. 34 illustrates a surgical hub 206 comprising a plurality of modulescoupled to the modular control tower 236. The modular control tower 236comprises a modular communication hub 203, e.g., a network connectivitydevice, and a computer system 210 to provide local processing,visualization, and imaging, for example. As shown in FIG. 34, themodular communication hub 203 may be connected in a tiered configurationto expand the number of modules (e.g., devices) that may be connected tothe modular communication hub 203 and transfer data associated with themodules to the computer system 210, cloud computing resources, or both.As shown in FIG. 34, each of the network hubs/switches in the modularcommunication hub 203 includes three downstream ports and one upstreamport. The upstream network hub/switch is connected to a processor toprovide a communication connection to the cloud computing resources anda local display 217. Communication to the cloud 204 may be made eitherthrough a wired or a wireless communication channel.

The surgical hub 206 employs a non-contact sensor module 242 to measurethe dimensions of the operating theater and generate a map of thesurgical theater using either ultrasonic or laser-type non-contactmeasurement devices. An ultrasound-based non-contact sensor module scansthe operating theater by transmitting a burst of ultrasound andreceiving the echo when it bounces off the perimeter walls of anoperating theater as described under the heading “Surgical Hub SpatialAwareness Within an Operating Room” in U.S. Provisional PatentApplication Ser. No. 62/611,341, titled INTERACTIVE SURGICAL PLATFORM,filed Dec. 28, 2017, the disclosure of which is herein incorporated byreference in its entirety, in which the sensor module is configured todetermine the size of the operating theater and to adjustBluetooth-pairing distance limits. A laser-based non-contact sensormodule scans the operating theater by transmitting laser light pulses,receiving laser light pulses that bounce off the perimeter walls of theoperating theater, and comparing the phase of the transmitted pulse tothe received pulse to determine the size of the operating theater and toadjust Bluetooth pairing distance limits, for example.

The computer system 210 comprises a processor 244 and a networkinterface 245. The processor 244 is coupled to a communication module247, storage 248, memory 249, non-volatile memory 250, and input/outputinterface 251 via a system bus. The system bus can be any of severaltypes of bus structure(s) including the memory bus or memory controller,a peripheral bus or external bus, and/or a local bus using any varietyof available bus architectures including, but not limited to, 9-bit bus,Industrial Standard Architecture (ISA), Micro-Charmel Architecture(MSA), Extended ISA (EISA), Intelligent Drive Electronics (IDE), VESALocal Bus (VLB), Peripheral Component Interconnect (PCI), USB, AdvancedGraphics Port (AGP), Personal Computer Memory Card InternationalAssociation bus (PCMCIA), Small Computer Systems Interface (SCSI), orany other proprietary bus.

The processor 244 may be any single-core or multicore processor such asthose known under the trade name ARM Cortex by Texas Instruments. In oneaspect, the processor may be an LM4F230H5QR ARM Cortex-M4F ProcessorCore, available from Texas Instruments, for example, comprising anon-chip memory of 256 KB single-cycle flash memory, or othernon-volatile memory, up to 40 MHz, a prefetch buffer to improveperformance above 40 MHz, a 32 KB single-cycle serial random accessmemory (SRAM), an internal read-only memory (ROM) loaded withStellarisWare® software, a 2 KB electrically erasable programmableread-only memory (EEPROM), and/or one or more pulse width modulation(PWM) modules, one or more quadrature encoder inputs (QEI) analogs, oneor more 12-bit analog-to-digital converters (ADCs) with 12 analog inputchannels, details of which are available for the product datasheet.

In one aspect, the processor 244 may comprise a safety controllercomprising two controller-based families such as TMS570 and RM4x, knownunder the trade name Hercules ARM Cortex R4, also by Texas Instruments.The safety controller may be configured specifically for IEC 61508 andISO 26262 safety critical applications, among others, to provideadvanced integrated safety features while delivering scalableperformance, connectivity, and memory options.

The system memory includes volatile memory and non-volatile memory. Thebasic input/output system (BIOS), containing the basic routines totransfer information between elements within the computer system, suchas during start-up, is stored in non-volatile memory. For example, thenon-volatile memory can include ROM, programmable ROM (PROM),electrically programmable ROM (EPROM), EEPROM, or flash memory. Volatilememory includes random-access memory (RAM), which acts as external cachememory. Moreover, RAM is available in many forms such as SRAM, dynamicRAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDRSDRAM), enhanced SDRAM (ESDRAM), Synchlink DRAM (SLDRAM), and directRambus RAM (DRRAM).

The computer system 210 also includes removable/non-removable,volatile/non-volatile computer storage media, such as for example diskstorage. The disk storage includes, but is not limited to, devices likea magnetic disk drive, floppy disk drive, tape drive, Jaz drive, Zipdrive, LS-60 drive, flash memory card, or memory stick. In addition, thedisk storage can include storage media separately or in combination withother storage media including, but not limited to, an optical disc drivesuch as a compact disc ROM device (CD-ROM), compact disc recordabledrive (CD-R Drive), compact disc rewritable drive (CD-RW Drive), or adigital versatile disc ROM drive (DVD-ROM). To facilitate the connectionof the disk storage devices to the system bus, a removable ornon-removable interface may be employed.

It is to be appreciated that the computer system 210 includes softwarethat acts as an intermediary between users and the basic computerresources described in a suitable operating environment. Such softwareincludes an operating system. The operating system, which can be storedon the disk storage, acts to control and allocate resources of thecomputer system. System applications take advantage of the management ofresources by the operating system through program modules and programdata stored either in the system memory or on the disk storage. It is tobe appreciated that various components described herein can beimplemented with various operating systems or combinations of operatingsystems.

A user enters commands or information into the computer system 210through input device(s) coupled to the I/O interface 251. The inputdevices include, but are not limited to, a pointing device such as amouse, trackball, stylus, touch pad, keyboard, microphone, joystick,game pad, satellite dish, scanner, TV tuner card, digital camera,digital video camera, web camera, and the like. These and other inputdevices connect to the processor through the system bus via interfaceport(s). The interface port(s) include, for example, a serial port, aparallel port, a game port, and a USB. The output device(s) use some ofthe same types of ports as input device(s). Thus, for example, a USBport may be used to provide input to the computer system and to outputinformation from the computer system to an output device. An outputadapter is provided to illustrate that there are some output deviceslike monitors, displays, speakers, and printers, among other outputdevices that require special adapters. The output adapters include, byway of illustration and not limitation, video and sound cards thatprovide a means of connection between the output device and the systembus. It should be noted that other devices and/or systems of devices,such as remote computer(s), provide both input and output capabilities.

The computer system 210 can operate in a networked environment usinglogical connections to one or more remote computers, such as cloudcomputer(s), or local computers. The remote cloud computer(s) can be apersonal computer, server, router, network PC, workstation,microprocessor-based appliance, peer device, or other common networknode, and the like, and typically includes many or all of the elementsdescribed relative to the computer system. For purposes of brevity, onlya memory storage device is illustrated with the remote computer(s). Theremote computer(s) is logically connected to the computer system througha network interface and then physically connected via a communicationconnection. The network interface encompasses communication networkssuch as local area networks (LANs) and wide area networks (WANs). LANtechnologies include Fiber Distributed Data Interface (FDDI), CopperDistributed Data Interface (CDDI), Ethernet/IEEE 802.3, Token Ring/IEEE802.5 and the like. WAN technologies include, but are not limited to,point-to-point links, circuit-switching networks like IntegratedServices Digital Networks (ISDN) and variations thereon,packet-switching networks, and Digital Subscriber Lines (DSL).

In various aspects, the computer system 210 of FIG. 34, the imagingmodule 238 and/or visualization system 208, and/or the processor module232 of FIGS. 9-10, may comprise an image processor, image processingengine, media processor, or any specialized digital signal processor(DSP) used for the processing of digital images. The image processor mayemploy parallel computing with single instruction, multiple data (SIMD)or multiple instruction, multiple data (MIMD) technologies to increasespeed and efficiency. The digital image processing engine can perform arange of tasks. The image processor may be a system on a chip withmulticore processor architecture.

The communication connection(s) refers to the hardware/software employedto connect the network interface to the bus. While the communicationconnection is shown for illustrative clarity inside the computer system,it can also be external to the computer system 210. Thehardware/software necessary for connection to the network interfaceincludes, for illustrative purposes only, internal and externaltechnologies such as modems, including regular telephone-grade modems,cable modems, and DSL modems, ISDN adapters, and Ethernet cards.

FIG. 35 illustrates a functional block diagram of one aspect of a USBnetwork hub 300 device, according to one aspect of the presentdisclosure. In the illustrated aspect, the USB network hub device 300employs a TUSB2036 integrated circuit hub by Texas Instruments. The USBnetwork hub 300 is a CMOS device that provides an upstream USBtransceiver port 302 and up to three downstream USB transceiver ports304, 306, 308 in compliance with the USB 2.0 specification. The upstreamUSB transceiver port 302 is a differential root data port comprising adifferential data minus (DM0) input paired with a differential data plus(DP0) input. The three downstream USB transceiver ports 304, 306, 308are differential data ports where each port includes differential dataplus (DP1-DP3) outputs paired with differential data minus (DM1-DM3)outputs.

The USB network hub 300 device is implemented with a digital statemachine instead of a microcontroller, and no firmware programming isrequired. Fully compliant USB transceivers are integrated into thecircuit for the upstream USB transceiver port 302 and all downstream USBtransceiver ports 304, 306, 308. The downstream USB transceiver ports304, 306, 308 support both full-speed and low-speed devices byautomatically setting the slew rate according to the speed of the deviceattached to the ports. The USB network hub 300 device may be configuredeither in bus-powered or self-powered mode and includes a hub powerlogic 312 to manage power.

The USB network hub 300 device includes a serial interface engine 310(SIE). The SIE 310 is the front end of the USB network hub 300 hardwareand handles most of the protocol described in chapter 8 of the USBspecification. The SIE 310 typically comprehends signaling up to thetransaction level. The functions that it handles could include: packetrecognition, transaction sequencing, SOP, EOP, RESET, and RESUME signaldetection/generation, clock/data separation, non-return-to-zero invert(NRZI) data encoding/decoding and bit-stuffing, CRC generation andchecking (token and data), packet ID (PID) generation andchecking/decoding, and/or serial-parallel/parallel-serial conversion.The 310 receives a clock input 314 and is coupled to a suspend/resumelogic and frame timer 316 circuit and a hub repeater circuit 318 tocontrol communication between the upstream USB transceiver port 302 andthe downstream USB transceiver ports 304, 306, 308 through port logiccircuits 320, 322, 324. The SIE 310 is coupled to a command decoder 326via interface logic to control commands from a serial EEPROM via aserial EEPROM interface 330.

In various aspects, the USB network hub 300 can connect 127 functionsconfigured in up to six logical layers (tiers) to a single computer.Further, the USB network hub 300 can connect to all peripherals using astandardized four-wire cable that provides both communication and powerdistribution. The power configurations are bus-powered and self-poweredmodes. The USB network hub 300 may be configured to support four modesof power management: a bus-powered hub, with either individual-portpower management or ganged-port power management, and the self-poweredhub, with either individual-port power management or ganged-port powermanagement. In one aspect, using a USB cable, the USB network hub 300,the upstream USB transceiver port 302 is plugged into a USB hostcontroller, and the downstream USB transceiver ports 304, 306, 308 areexposed for connecting USB compatible devices, and so forth.

Surgical Instrument Hardware

FIG. 36 illustrates a logic diagram of a control system 470 of asurgical instrument or tool in accordance with one or more aspects ofthe present disclosure. The system 470 comprises a control circuit. Thecontrol circuit includes a microcontroller 461 comprising a processor462 and a memory 468. One or more of sensors 472, 474, 476, for example,provide real-time feedback to the processor 462. A motor 482, driven bya motor driver 492, operably couples a longitudinally movabledisplacement member to drive the I-beam knife element. A tracking system480 is configured to determine the position of the longitudinallymovable displacement member. The position information is provided to theprocessor 462, which can be programmed or configured to determine theposition of the longitudinally movable drive member as well as theposition of a firing member, firing bar, and I-beam knife element.Additional motors may be provided at the tool driver interface tocontrol I-beam firing, closure tube travel, shaft rotation, andarticulation. A display 473 displays a variety of operating conditionsof the instruments and may include touch screen functionality for datainput. Information displayed on the display 473 may be overlaid withimages acquired via endoscopic imaging modules.

In one aspect, the microcontroller 461 may be any single-core ormulticore processor such as those known under the trade name ARM Cortexby Texas Instruments. In one aspect, the main microcontroller 461 may bean LM4F230H5QR ARM Cortex-M4F Processor Core, available from TexasInstruments, for example, comprising an on-chip memory of 256 KBsingle-cycle flash memory, or other non-volatile memory, up to 40 MHz, aprefetch buffer to improve performance above 40 MHz, a 32 KBsingle-cycle SRAM, and internal ROM loaded with StellarisWare® software,a 2 KB EEPROM, one or more PWM modules, one or more QEI analogs, and/orone or more 12-bit ADCs with 12 analog input channels, details of whichare available for the product datasheet.

In one aspect, the microcontroller 461 may comprise a safety controllercomprising two controller-based families such as TMS570 and RM4x, knownunder the trade name Hercules ARM Cortex R4, also by Texas Instruments.The safety controller may be configured specifically for IEC 61508 andISO 26262 safety critical applications, among others, to provideadvanced integrated safety features while delivering scalableperformance, connectivity, and memory options.

The microcontroller 461 may be programmed to perform various functionssuch as precise control over the speed and position of the knife andarticulation systems. In one aspect, the microcontroller 461 includes aprocessor 462 and a memory 468. The electric motor 482 may be a brusheddirect current (DC) motor with a gearbox and mechanical links to anarticulation or knife system. In one aspect, a motor driver 492 may bean A3941 available from Allegro Microsystems, Inc. Other motor driversmay be readily substituted for use in the tracking system 480 comprisingan absolute positioning system. A detailed description of an absolutepositioning system is described in U.S. Patent Application PublicationNo. 2017/0296213, titled SYSTEMS AND METHODS FOR CONTROLLING A SURGICALSTAPLING AND CUTTING INSTRUMENT, which published on Oct. 19, 2017, whichis herein incorporated by reference in its entirety.

The microcontroller 461 may be programmed to provide precise controlover the speed and position of displacement members and articulationsystems. The microcontroller 461 may be configured to compute a responsein the software of the microcontroller 461. The computed response iscompared to a measured response of the actual system to obtain an“observed” response, which is used for actual feedback decisions. Theobserved response is a favorable, tuned value that balances the smooth,continuous nature of the simulated response with the measured response,which can detect outside influences on the system.

In one aspect, the motor 482 may be controlled by the motor driver 492and can be employed by the firing system of the surgical instrument ortool. In various forms, the motor 482 may be a brushed DC driving motorhaving a maximum rotational speed of approximately 25,000 RPM. In otherarrangements, the motor 482 may include a brushless motor, a cordlessmotor, a synchronous motor, a stepper motor, or any other suitableelectric motor. The motor driver 492 may comprise an H-bridge drivercomprising field-effect transistors (FETs), for example. The motor 482can be powered by a power assembly releasably mounted to the handleassembly or tool housing for supplying control power to the surgicalinstrument or tool. The power assembly may comprise a battery which mayinclude a number of battery cells connected in series that can be usedas the power source to power the surgical instrument or tool. In certaincircumstances, the battery cells of the power assembly may bereplaceable and/or rechargeable. In at least one example, the batterycells can be lithium-ion batteries which can be couplable to andseparable from the power assembly.

The motor driver 492 may be an A3941 available from AllegroMicrosystems, Inc. The A3941 492 is a full-bridge controller for usewith external N-channel power metal-oxide semiconductor field-effecttransistors (MOSFETs) specifically designed for inductive loads, such asbrush DC motors. The driver 492 comprises a unique charge pump regulatorthat provides full (>10 V) gate drive for battery voltages down to 7 Vand allows the A3941 to operate with a reduced gate drive, down to 5.5V. A bootstrap capacitor may be employed to provide the above batterysupply voltage required for N-channel MOSFETs. An internal charge pumpfor the high-side drive allows DC (100% duty cycle) operation. The fullbridge can be driven in fast or slow decay modes using diode orsynchronous rectification. In the slow decay mode, current recirculationcan be through the high-side or the lowside FETs. The power FETs areprotected from shoot-through by resistor-adjustable dead time.Integrated diagnostics provide indications of undervoltage,overtemperature, and power bridge faults and can be configured toprotect the power MOSFETs under most short circuit conditions. Othermotor drivers may be readily substituted for use in the tracking system480 comprising an absolute positioning system.

The tracking system 480 comprises a controlled motor drive circuitarrangement comprising a position sensor 472 according to one aspect ofthis disclosure. The position sensor 472 for an absolute positioningsystem provides a unique position signal corresponding to the locationof a displacement member. In one aspect, the displacement memberrepresents a longitudinally movable drive member comprising a rack ofdrive teeth for meshing engagement with a corresponding drive gear of agear reducer assembly. In other aspects, the displacement memberrepresents the firing member, which could be adapted and configured toinclude a rack of drive teeth. In yet another aspect, the displacementmember represents a firing bar or the !-beam, each of which can beadapted and configured to include a rack of drive teeth. Accordingly, asused herein, the term displacement member is used generically to referto any movable member of the surgical instrument or tool such as thedrive member, the firing member, the firing bar, the I-beam, or anyelement that can be displaced. In one aspect, the longitudinally movabledrive member is coupled to the firing member, the firing bar, and the!-beam. Accordingly, the absolute positioning system can, in effect,track the linear displacement of the I-beam by tracking the lineardisplacement of the longitudinally movable drive member. In variousother aspects, the displacement member may be coupled to any positionsensor 472 suitable for measuring linear displacement. Thus, thelongitudinally movable drive member, the firing member, the firing bar,or the I-beam, or combinations thereof, may be coupled to any suitablelinear displacement sensor. Linear displacement sensors may includecontact or non-contact displacement sensors. Linear displacement sensorsmay comprise linear variable differential transformers (LVDT),differential variable reluctance transducers (DVRT), a slidepotentiometer, a magnetic sensing system comprising a movable magnet anda series of linearly arranged Hall effect sensors, a magnetic sensingsystem comprising a fixed magnet and a series of movable, linearlyarranged Hall effect sensors, an optical sensing system comprising amovable light source and a series of linearly arranged photo diodes orphoto detectors, an optical sensing system comprising a fixed lightsource and a series of movable linearly, arranged photo diodes or photodetectors, or any combination thereof.

The electric motor 482 can include a rotatable shaft that operablyinterfaces with a gear assembly that is mounted in meshing engagementwith a set, or rack, of drive teeth on the displacement member. A sensorelement may be operably coupled to a gear assembly such that a singlerevolution of the position sensor 472 element corresponds to some linearlongitudinal translation of the displacement member. An arrangement ofgearing and sensors can be connected to the linear actuator, via a rackand pinion arrangement, or a rotary actuator, via a spur gear or otherconnection. A power source supplies power to the absolute positioningsystem and an output indicator may display the output of the absolutepositioning system. The displacement member represents thelongitudinally movable drive member comprising a rack of drive teethformed thereon for meshing engagement with a corresponding drive gear ofthe gear reducer assembly. The displacement member represents thelongitudinally movable firing member, firing bar, I-beam, orcombinations thereof.

A single revolution of the sensor element associated with the positionsensor 472 is equivalent to a longitudinal linear displacement d1 of theof the displacement member, where d1 is the longitudinal linear distancethat the displacement member moves from point “a” to point “b” after asingle revolution of the sensor element coupled to the displacementmember. The sensor arrangement may be connected via a gear reductionthat results in the position sensor 472 completing one or morerevolutions for the full stroke of the displacement member. The positionsensor 472 may complete multiple revolutions for the full stroke of thedisplacement member.

A series of switches, where n is an integer greater than one, may beemployed alone or in combination with a gear reduction to provide aunique position signal for more than one revolution of the positionsensor 472. The state of the switches are fed back to themicrocontroller 461 that applies logic to determine a unique positionsignal corresponding to the longitudinal linear displacement d1+d2+ . .. dn of the displacement member. The output of the position sensor 472is provided to the microcontroller 461. The position sensor 472 of thesensor arrangement may comprise a magnetic sensor, an analog rotarysensor like a potentiometer, or an array of analog Hall-effect elements,which output a unique combination of position signals or values.

The position sensor 472 may comprise any number of magnetic sensingelements, such as, for example, magnetic sensors classified according towhether they measure the total magnetic field or the vector componentsof the magnetic field. The techniques used to produce both types ofmagnetic sensors encompass many aspects of physics and electronics. Thetechnologies used for magnetic field sensing include search coil,fluxgate, optically pumped, nuclear precession, SQUID, Hall-effect,anisotropic magnetoresistance, giant magnetoresistance, magnetic tunneljunctions, giant magnetoimpedance, magnetostrictive/piezoelectriccomposites, magnetodiode, magnetotransistor, fiber-optic, magneto-optic,and microelectromechanical systems-based magnetic sensors, among others.

In one aspect, the position sensor 472 for the tracking system 480comprising an absolute positioning system comprises a magnetic rotaryabsolute positioning system. The position sensor 472 may be implementedas an AS5055EQFT single-chip magnetic rotary position sensor availablefrom Austria Microsystems, AG. The position sensor 472 is interfacedwith the microcontroller 461 to provide an absolute positioning system.The position sensor 472 is a low-voltage and low-power component andincludes four Hall-effect elements in an area of the position sensor 472that is located above a magnet. A high-resolution ADC and a smart powermanagement controller are also provided on the chip. A coordinaterotation digital computer (CORDIC) processor, also known as thedigit-by-digit method and Volder's algorithm, is provided to implement asimple and efficient algorithm to calculate hyperbolic and trigonometricfunctions that require only addition, subtraction, bitshift, and tablelookup operations. The angle position, alarm bits, and magnetic fieldinformation are transmitted over a standard serial communicationinterface, such as a serial peripheral interface (SPI) interface, to themicrocontroller 461. The position sensor 472 provides 12 or 14 bits ofresolution. The position sensor 472 may be an AS5055 chip provided in asmall QFN 16-pin 4×4×0.85 mm package.

The tracking system 480 comprising an absolute positioning system maycomprise and/or be programmed to implement a feedback controller, suchas a PID, state feedback, and adaptive controller. A power sourceconverts the signal from the feedback controller into a physical inputto the system: in this case the voltage. Other examples include a PWM ofthe voltage, current, and force. Other sensor(s) may be provided tomeasure physical parameters of the physical system in addition to theposition measured by the position sensor 472. In some aspects, the othersensor(s) can include sensor arrangements such as those described inU.S. Pat. No. 9,345,481, titled STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM, which issued on May 24, 2016, which is herein incorporated byreference in its entirety; U.S. Patent Application Publication No.2014/0263552, titled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM,which published on Sep. 18, 2014, which is herein incorporated byreference in its entirety; and U.S. patent application Ser. No.15/628,175, titled TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OFA SURGICAL STAPLING AND CUTTING INSTRUMENT, filed Jun. 20, 2017, whichis herein incorporated by reference in its entirety. In a digital signalprocessing system, an absolute positioning system is coupled to adigital data acquisition system where the output of the absolutepositioning system will have a finite resolution and sampling frequency.The absolute positioning system may comprise a compare-and-combinecircuit to combine a computed response with a measured response usingalgorithms, such as a weighted average and a theoretical control loop,that drive the computed response towards the measured response. Thecomputed response of the physical system takes into account propertieslike mass, inertial, viscous friction, inductance resistance, etc., topredict what the states and outputs of the physical system will be byknowing the input.

The absolute positioning system provides an absolute position of thedisplacement member upon power-up of the instrument, without retractingor advancing the displacement member to a reset (zero or home) positionas may be required with conventional rotary encoders that merely countthe number of steps forwards or backwards that the motor 482 has takento infer the position of a device actuator, drive bar, knife, or thelike.

A sensor 474, such as, for example, a strain gauge or a micro-straingauge, is configured to measure one or more parameters of the endeffector, such as, for example, the amplitude of the strain exerted onthe anvil during a clamping operation, which can be indicative of theclosure forces applied to the anvil. The measured strain is converted toa digital signal and provided to the processor 462. Alternatively, or inaddition to the sensor 474, a sensor 476, such as, for example, a loadsensor, can measure the closure force applied by the closure drivesystem to the anvil. The sensor 476, such as, for example, a loadsensor, can measure the firing force applied to an I-beam in a firingstroke of the surgical instrument or tool. The I-beam is configured toengage a wedge sled, which is configured to upwardly cam staple driversto force out staples into deforming contact with an anvil. The I-beamalso includes a sharpened cutting edge that can be used to sever tissueas the I-beam is advanced distally by the firing bar. Alternatively, acurrent sensor 478 can be employed to measure the current drawn by themotor 482. The force required to advance the firing member cancorrespond to the current drawn by the motor 482, for example. Themeasured force is converted to a digital signal and provided to theprocessor 462.

In one form, the strain gauge sensor 474 can be used to measure theforce applied to the tissue by the end effector. A strain gauge can becoupled to the end effector to measure the force on the tissue beingtreated by the end effector. A system for measuring forces applied tothe tissue grasped by the end effector comprises a strain gauge sensor474, such as, for example, a micro-strain gauge, that is configured tomeasure one or more parameters of the end effector, for example. In oneaspect, the strain gauge sensor 474 can measure the amplitude ormagnitude of the strain exerted on a jaw member of an end effectorduring a clamping operation, which can be indicative of the tissuecompression. The measured strain is converted to a digital signal andprovided to a processor 462 of the microcontroller 461. A load sensor476 can measure the force used to operate the knife element, forexample, to cut the tissue captured between the anvil and the staplecartridge. A magnetic field sensor can be employed to measure thethickness of the captured tissue. The measurement of the magnetic fieldsensor also may be converted to a digital signal and provided to theprocessor 462.

The measurements of the tissue compression, the tissue thickness, and/orthe force required to close the end effector on the tissue, asrespectively measured by the sensors 474, 476, can be used by themicrocontroller 461 to characterize the selected position of the firingmember and/or the corresponding value of the speed of the firing member.In one instance, a memory 468 may store a technique, an equation, and/ora lookup table which can be employed by the microcontroller 461 in theassessment.

The control system 470 of the surgical instrument or tool also maycomprise wired or wireless communication circuits to communicate withthe modular communication hub as shown in FIGS. 8-11.

FIG. 37 illustrates a control circuit 500 configured to control aspectsof the surgical instrument or tool according to one aspect of thisdisclosure. The control circuit 500 can be configured to implementvarious processes described herein. The control circuit 500 may comprisea microcontroller comprising one or more processors 502 (e.g.,microprocessor, microcontroller) coupled to at least one memory circuit504. The memory circuit 504 stores machine-executable instructions that,when executed by the processor 502, cause the processor 502 to executemachine instructions to implement various processes described herein.The processor 502 may be any one of a number of single-core or multicoreprocessors known in the art. The memory circuit 504 may comprisevolatile and non-volatile storage media. The processor 502 may includean instruction processing unit 506 and an arithmetic unit 508. Theinstruction processing unit may be configured to receive instructionsfrom the memory circuit 504 of this disclosure.

FIG. 38 illustrates a combinational logic circuit 510 configured tocontrol aspects of the surgical instrument or tool according to oneaspect of this disclosure. The combinational logic circuit 510 can beconfigured to implement various processes described herein. Thecombinational logic circuit 510 may comprise a finite state machinecomprising a combinational logic 512 configured to receive dataassociated with the surgical instrument or tool at an input 514, processthe data by the combinational logic 512, and provide an output 516.

FIG. 39 illustrates a sequential logic circuit 520 configured to controlaspects of the surgical instrument or tool according to one aspect ofthis disclosure. The sequential logic circuit 520 or the combinationallogic 522 can be configured to implement various processes describedherein. The sequential logic circuit 520 may comprise a finite statemachine. The sequential logic circuit 520 may comprise a combinationallogic 522, at least one memory circuit 524, and a clock 529, forexample. The at least one memory circuit 524 can store a current stateof the finite state machine. In certain instances, the sequential logiccircuit 520 may be synchronous or asynchronous. The combinational logic522 is configured to receive data associated with the surgicalinstrument or tool from an input 526, process the data by thecombinational logic 522, and provide an output 528. In other aspects,the circuit may comprise a combination of a processor (e.g., processor502, FIG. 37) and a finite state machine to implement various processesherein. In other aspects, the finite state machine may comprise acombination of a combinational logic circuit (e.g., combinational logiccircuit 510, FIG. 38) and the sequential logic circuit 520.

FIG. 40 illustrates a surgical instrument or tool comprising a pluralityof motors which can be activated to perform various functions. Incertain instances, a first motor can be activated to perform a firstfunction, a second motor can be activated to perform a second function,a third motor can be activated to perform a third function, a fourthmotor can be activated to perform a fourth function, and so on. Incertain instances, the plurality of motors of robotic surgicalinstrument 600 can be individually activated to cause firing, closure,and/or articulation motions in the end effector. The firing, closure,and/or articulation motions can be transmitted to the end effectorthrough a shaft assembly, for example.

In certain instances, the surgical instrument system or tool may includea firing motor 602. The firing motor 602 may be operably coupled to afiring motor drive assembly 604 which can be configured to transmitfiring motions, generated by the motor 602 to the end effector, inparticular to displace the I-beam element. In certain instances, thefiring motions generated by the motor 602 may cause the staples to bedeployed from the staple cartridge into tissue captured by the endeffector and/or the cutting edge of the I-beam element to be advanced tocut the captured tissue, for example. The I-beam element may beretracted by reversing the direction of the motor 602.

In certain instances, the surgical instrument or tool may include aclosure motor 603. The closure motor 603 may be operably coupled to aclosure motor drive assembly 605 which can be configured to transmitclosure motions, generated by the motor 603 to the end effector, inparticular to displace a closure tube to close the anvil and compresstissue between the anvil and the staple cartridge. The closure motionsmay cause the end effector to transition from an open configuration toan approximated configuration to capture tissue, for example. The endeffector may be transitioned to an open position by reversing thedirection of the motor 603.

In certain instances, the surgical instrument or tool may include one ormore articulation motors 606 a, 606 b, for example. The motors 606 a,606 b may be operably coupled to respective articulation motor driveassemblies 608 a, 608 b, which can be configured to transmitarticulation motions generated by the motors 606 a, 606 b to the endeffector. In certain instances, the articulation motions may cause theend effector to articulate relative to the shaft, for example.

As described above, the surgical instrument or tool may include aplurality of motors which may be configured to perform variousindependent functions. In certain instances, the plurality of motors ofthe surgical instrument or tool can be individually or separatelyactivated to perform one or more functions while the other motors remaininactive. For example, the articulation motors 606 a, 606 b can beactivated to cause the end effector to be articulated while the firingmotor 602 remains inactive. Alternatively, the firing motor 602 can beactivated to fire the plurality of staples, and/or to advance thecutting edge, while the articulation motor 606 remains inactive.Furthermore the closure motor 603 may be activated simultaneously withthe firing motor 602 to cause the closure tube and the I-beam element toadvance distally as described in more detail hereinbelow.

In certain instances, the surgical instrument or tool may include acommon control module 610 which can be employed with a plurality ofmotors of the surgical instrument or tool. In certain instances, thecommon control module 610 may accommodate one of the plurality of motorsat a time. For example, the common control module 610 can be couplableto and separable from the plurality of motors of the robotic surgicalinstrument individually. In certain instances, a plurality of the motorsof the surgical instrument or tool may share one or more common controlmodules such as the common control module 610. In certain instances, aplurality of motors of the surgical instrument or tool can beindividually and selectively engaged with the common control module 610.In certain instances, the common control module 610 can be selectivelyswitched from interfacing with one of a plurality of motors of thesurgical instrument or tool to interfacing with another one of theplurality of motors of the surgical instrument or tool.

In at least one example, the common control module 610 can beselectively switched between operable engagement with the articulationmotors 606 a, 606 b and operable engagement with either the firing motor602 or the closure motor 603. In at least one example, as illustrated inFIG. 40, a switch 614 can be moved or transitioned between a pluralityof positions and/or states. In a first position 616, the switch 614 mayelectrically couple the common control module 610 to the firing motor602; in a second position 617, the switch 614 may electrically couplethe common control module 610 to the closure motor 603; in a thirdposition 618 a, the switch 614 may electrically couple the commoncontrol module 610 to the first articulation motor 606 a; and in afourth position 618 b, the switch 614 may electrically couple the commoncontrol module 610 to the second articulation motor 606 b, for example.In certain instances, separate common control modules 610 can beelectrically coupled to the firing motor 602, the closure motor 603, andthe articulations motor 606 a, 606 b at the same time. In certaininstances, the switch 614 may be a mechanical switch, anelectromechanical switch, a solid-state switch, or any suitableswitching mechanism.

Each of the motors 602, 603, 606 a, 606 b may comprise a torque sensorto measure the output torque on the shaft of the motor. The force on anend effector may be sensed in any conventional manner, such as by forcesensors on the outer sides of the jaws or by a torque sensor for themotor actuating the jaws.

In various instances, as illustrated in FIG. 40, the common controlmodule 610 may comprise a motor driver 626 which may comprise one ormore H-Bridge FETs. The motor driver 626 may modulate the powertransmitted from a power source 628 to a motor coupled to the commoncontrol module 610 based on input from a microcontroller 620 (the“controller”), for example. In certain instances, the microcontroller620 can be employed to determine the current drawn by the motor, forexample, while the motor is coupled to the common control module 610, asdescribed above.

In certain instances, the microcontroller 620 may include amicroprocessor 622 (the “processor”) and one or more non-transitorycomputer-readable mediums or memory units 624 (the “memory”). In certaininstances, the memory 624 may store various program instructions, whichwhen executed may cause the processor 622 to perform a plurality offunctions and/or calculations described herein. In certain instances,one or more of the memory units 624 may be coupled to the processor 622,for example.

In certain instances, the power source 628 can be employed to supplypower to the microcontroller 620, for example. In certain instances, thepower source 628 may comprise a battery (or “battery pack” or “powerpack”), such as a lithium-ion battery, for example. In certaininstances, the battery pack may be configured to be releasably mountedto a handle for supplying power to the surgical instrument 600. A numberof battery cells connected in series may be used as the power source628. In certain instances, the power source 628 may be replaceableand/or rechargeable, for example.

In various instances, the processor 622 may control the motor driver 626to control the position, direction of rotation, and/or velocity of amotor that is coupled to the common control module 610. In certaininstances, the processor 622 can signal the motor driver 626 to stopand/or disable a motor that is coupled to the common control module 610.It should be understood that the term “processor” as used hereinincludes any suitable microprocessor, microcontroller, or other basiccomputing device that incorporates the functions of a computer's centralprocessing unit (CPU) on an integrated circuit or, at most, a fewintegrated circuits. The processor is a multipurpose, programmabledevice that accepts digital data as input, processes it according toinstructions stored in its memory, and provides results as output. It isan example of sequential digital logic, as it has internal memory.Processors operate on numbers and symbols represented in the binarynumeral system.

In one instance, the processor 622 may be any single-core or multicoreprocessor such as those known under the trade name ARM Cortex by TexasInstruments. In certain instances, the microcontroller 620 may be an LM4F230H5QR, available from Texas Instruments, for example. In at leastone example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4FProcessor Core comprising an on-chip memory of 256 KB single-cycle flashmemory, or other non-volatile memory, up to 40 MHz, a prefetch buffer toimprove performance above 40 MHz, a 32 KB single-cycle SRAM, an internalROM loaded with StellarisWare® software, a 2 KB EEPROM, one or more PWMmodules, one or more QEI analogs, one or more 12-bit ADCs with 12 analoginput channels, among other features that are readily available for theproduct datasheet. Other microcontrollers may be readily substituted foruse with the module 4410. Accordingly, the present disclosure should notbe limited in this context.

In certain instances, the memory 624 may include program instructionsfor controlling each of the motors of the surgical instrument 600 thatare couplable to the common control module 610. For example, the memory624 may include program instructions for controlling the firing motor602, the closure motor 603, and the articulation motors 606 a, 606 b.Such program instructions may cause the processor 622 to control thefiring, closure, and articulation functions in accordance with inputsfrom algorithms or control programs of the surgical instrument or tool.

In certain instances, one or more mechanisms and/or sensors such as, forexample, sensors 630 can be employed to alert the processor 622 to theprogram instructions that should be used in a particular setting. Forexample, the sensors 630 may alert the processor 622 to use the programinstructions associated with firing, closing, and articulating the endeffector. In certain instances, the sensors 630 may comprise positionsensors which can be employed to sense the position of the switch 614,for example. Accordingly, the processor 622 may use the programinstructions associated with firing the I-beam of the end effector upondetecting, through the sensors 630 for example, that the switch 614 isin the first position 616; the processor 622 may use the programinstructions associated with closing the anvil upon detecting, throughthe sensors 630 for example, that the switch 614 is in the secondposition 617; and the processor 622 may use the program instructionsassociated with articulating the end effector upon detecting, throughthe sensors 630 for example, that the switch 614 is in the third orfourth position 618 a, 618 b.

FIG. 41 is a schematic diagram of a robotic surgical instrument 700configured to operate a surgical tool described herein according to oneaspect of this disclosure. The robotic surgical instrument 700 may beprogrammed or configured to control distal/proximal translation of adisplacement member, distal/proximal displacement of a closure tube,shaft rotation, and articulation, either with single or multiplearticulation drive links. In one aspect, the surgical instrument 700 maybe programmed or configured to individually control a firing member, aclosure member, a shaft member, and/or one or more articulation members.The surgical instrument 700 comprises a control circuit 710 configuredto control motor-driven firing members, closure members, shaft members,and/or one or more articulation members.

In one aspect, the robotic surgical instrument 700 comprises a controlcircuit 710 configured to control an anvil 716 and an I-beam 714(including a sharp cutting edge) portion of an end effector 702, aremovable staple cartridge 718, a shaft 740, and one or morearticulation members 742 a, 742 b via a plurality of motors 704 a-704 e.A position sensor 734 may be configured to provide position feedback ofthe I-beam 714 to the control circuit 710. Other sensors 738 may beconfigured to provide feedback to the control circuit 710. Atimer/counter 731 provides timing and counting information to thecontrol circuit 710. An energy source 712 may be provided to operate themotors 704 a-704 e, and a current sensor 736 provides motor currentfeedback to the control circuit 710. The motors 704 a-704 e can beoperated individually by the control circuit 710 in an open-loop orclosed-loop feedback control.

In one aspect, the control circuit 710 may comprise one or moremicrocontrollers, microprocessors, or other suitable processors forexecuting instructions that cause the processor or processors to performone or more tasks. In one aspect, a timer/counter 731 provides an outputsignal, such as the elapsed time or a digital count, to the controlcircuit 710 to correlate the position of the I-beam 714 as determined bythe position sensor 734 with the output of the timer/counter 731 suchthat the control circuit 710 can determine the position of the I-beam714 at a specific time (t) relative to a starting position or the time(t) when the I-beam 714 is at a specific position relative to a startingposition. The timer/counter 731 may be configured to measure elapsedtime, count external events, or time external events.

In one aspect, the control circuit 710 may be programmed to controlfunctions of the end effector 702 based on one or more tissueconditions. The control circuit 710 may be programmed to sense tissueconditions, such as thickness, either directly or indirectly, asdescribed herein. The control circuit 710 may be programmed to select afiring control program or closure control program based on tissueconditions. A firing control program may describe the distal motion ofthe displacement member. Different firing control programs may beselected to better treat different tissue conditions. For example, whenthicker tissue is present, the control circuit 710 may be programmed totranslate the displacement member at a lower velocity and/or with lowerpower. When thinner tissue is present, the control circuit 710 may beprogrammed to translate the displacement member at a higher velocityand/or with higher power. A closure control program may control theclosure force applied to the tissue by the anvil 716. Other controlprograms control the rotation of the shaft 740 and the articulationmembers 742 a, 742 b.

In one aspect, the control circuit 710 may generate motor set pointsignals. The motor set point signals may be provided to various motorcontrollers 708 a-708 e. The motor controllers 708 a-708 e may compriseone or more circuits configured to provide motor drive signals to themotors 704 a-704 e to drive the motors 704 a-704 e as described herein.In some examples, the motors 704 a-704 e may be brushed DC electricmotors. For example, the velocity of the motors 704 a-704 e may beproportional to the respective motor drive signals. In some examples,the motors 704 a-704 e may be brushless DC electric motors, and therespective motor drive signals may comprise a PWM signal provided to oneor more stator windings of the motors 704 a-704 e. Also, in someexamples, the motor controllers 708 a-708 e may be omitted and thecontrol circuit 710 may generate the motor drive signals directly.

In one aspect, the control circuit 710 may initially operate each of themotors 704 a-704 e in an open-loop configuration for a first open-loopportion of a stroke of the displacement member. Based on the response ofthe robotic surgical instrument 700 during the open-loop portion of thestroke, the control circuit 710 may select a firing control program in aclosed-loop configuration. The response of the instrument may include atranslation distance of the displacement member during the open-loopportion, a time elapsed during the open-loop portion, the energyprovided to one of the motors 704 a-704 e during the open-loop portion,a sum of pulse widths of a motor drive signal, etc. After the open-loopportion, the control circuit 710 may implement the selected firingcontrol program for a second portion of the displacement member stroke.For example, during a closed-loop portion of the stroke, the controlcircuit 710 may modulate one of the motors 704 a-704 e based ontranslation data describing a position of the displacement member in aclosed-loop manner to translate the displacement member at a constantvelocity.

In one aspect, the motors 704 a-704 e may receive power from an energysource 712. The energy source 712 may be a DC power supply driven by amain alternating current power source, a battery, a super capacitor, orany other suitable energy source. The motors 704 a-704 e may bemechanically coupled to individual movable mechanical elements such asthe !-beam 714, anvil 716, shaft 740, articulation 742 a, andarticulation 742 b via respective transmissions 706 a-706 e. Thetransmissions 706 a-706 e may include one or more gears or other linkagecomponents to couple the motors 704 a-704 e to movable mechanicalelements. A position sensor 734 may sense a position of the I-beam 714.The position sensor 734 may be or include any type of sensor that iscapable of generating position data that indicate a position of theI-beam 714. In some examples, the position sensor 734 may include anencoder configured to provide a series of pulses to the control circuit710 as the I-beam 714 translates distally and proximally. The controlcircuit 710 may track the pulses to determine the position of the I-beam714. Other suitable position sensors may be used, including, forexample, a proximity sensor. Other types of position sensors may provideother signals indicating motion of the I-beam 714. Also, in someexamples, the position sensor 734 may be omitted. Where any of themotors 704 a-704 e is a stepper motor, the control circuit 710 may trackthe position of the I-beam 714 by aggregating the number and directionof steps that the motor 704 has been instructed to execute. The positionsensor 734 may be located in the end effector 702 or at any otherportion of the instrument. The outputs of each of the motors 704 a-704 einclude a torque sensor 744 a-744 e to sense force and have an encoderto sense rotation of the drive shaft.

In one aspect, the control circuit 710 is configured to drive a firingmember such as the I-beam 714 portion of the end effector 702. Thecontrol circuit 710 provides a motor set point to a motor control 708 a,which provides a drive signal to the motor 704 a. The output shaft ofthe motor 704 a is coupled to a torque sensor 744 a. The torque sensor744 a is coupled to a transmission 706 a which is coupled to the I-beam714. The transmission 706 a comprises movable mechanical elements suchas rotating elements and a firing member to control the movement of theI-beam 714 distally and proximally along a longitudinal axis of the endeffector 702. In one aspect, the motor 704 a may be coupled to the knifegear assembly, which includes a knife gear reduction set that includes afirst knife drive gear and a second knife drive gear. A torque sensor744 a provides a firing force feedback signal to the control circuit710. The firing force signal represents the force required to fire ordisplace the I-beam 714. A position sensor 734 may be configured toprovide the position of the I-beam 714 along the firing stroke or theposition of the firing member as a feedback signal to the controlcircuit 710. The end effector 702 may include additional sensors 738configured to provide feedback signals to the control circuit 710. Whenready to use, the control circuit 710 may provide a firing signal to themotor control 708 a. In response to the firing signal, the motor 704 amay drive the firing member distally along the longitudinal axis of theend effector 702 from a proximal stroke start position to a stroke endposition distal to the stroke start position. As the firing membertranslates distally, an I-beam 714, with a cutting element positioned ata distal end, advances distally to cut tissue located between the staplecartridge 718 and the anvil 716.

In one aspect, the control circuit 710 is configured to drive a closuremember such as the anvil 716 portion of the end effector 702. Thecontrol circuit 710 provides a motor set point to a motor control 708 b,which provides a drive signal to the motor 704 b. The output shaft ofthe motor 704 b is coupled to a torque sensor 744 b. The torque sensor744 b is coupled to a transmission 706 b which is coupled to the anvil716. The transmission 706 b comprises movable mechanical elements suchas rotating elements and a closure member to control the movement of theanvil 716 from the open and closed positions. In one aspect, the motor704 b is coupled to a closure gear assembly, which includes a closurereduction gear set that is supported in meshing engagement with theclosure spur gear. The torque sensor 744 b provides a closure forcefeedback signal to the control circuit 710. The closure force feedbacksignal represents the closure force applied to the anvil 716. Theposition sensor 734 may be configured to provide the position of theclosure member as a feedback signal to the control circuit 710.Additional sensors 738 in the end effector 702 may provide the closureforce feedback signal to the control circuit 710. The pivotable anvil716 is positioned opposite the staple cartridge 718. When ready to use,the control circuit 710 may provide a closure signal to the motorcontrol 708 b. In response to the closure signal, the motor 704 badvances a closure member to grasp tissue between the anvil 716 and thestaple cartridge 718.

In one aspect, the control circuit 710 is configured to rotate a shaftmember such as the shaft 740 to rotate the end effector 702. The controlcircuit 710 provides a motor set point to a motor control 708 c, whichprovides a drive signal to the motor 704 c. The output shaft of themotor 704 c is coupled to a torque sensor 744 c. The torque sensor 744 cis coupled to a transmission 706 c which is coupled to the shaft 740.The transmission 706 c comprises movable mechanical elements such asrotating elements to control the rotation of the shaft 740 clockwise orcounterclockwise up to and over 360°. In one aspect, the motor 704 c iscoupled to the rotational transmission assembly, which includes a tubegear segment that is formed on (or attached to) the proximal end of theproximal closure tube for operable engagement by a rotational gearassembly that is operably supported on the tool mounting plate. Thetorque sensor 744 c provides a rotation force feedback signal to thecontrol circuit 710. The rotation force feedback signal represents therotation force applied to the shaft 740. The position sensor 734 may beconfigured to provide the position of the closure member as a feedbacksignal to the control circuit 710. Additional sensors 738 such as ashaft encoder may provide the rotational position of the shaft 740 tothe control circuit 710.

In one aspect, the control circuit 710 is configured to articulate theend effector 702. The control circuit 710 provides a motor set point toa motor control 708 d, which provides a drive signal to the motor 704 d.The output shaft of the motor 704 d is coupled to a torque sensor 744 d.The torque sensor 744 d is coupled to a transmission 706 d which iscoupled to an articulation member 742 a. The transmission 706 dcomprises movable mechanical elements such as articulation elements tocontrol the articulation of the end effector 702±65°. In one aspect, themotor 704 d is coupled to an articulation nut, which is rotatablyjournaled on the proximal end portion of the distal spine portion and isrotatably driven thereon by an articulation gear assembly. The torquesensor 744 d provides an articulation force feedback signal to thecontrol circuit 710. The articulation force feedback signal representsthe articulation force applied to the end effector 702. Sensors 738,such as an articulation encoder, may provide the articulation positionof the end effector 702 to the control circuit 710.

In another aspect, the articulation function of the robotic surgicalsystem 700 may comprise two articulation members, or links, 742 a, 742b. These articulation members 742 a, 742 b are driven by separate diskson the robot interface (the rack), which are driven by the two motors708 d, 708 e. When the separate firing motor 704 a is provided, each ofarticulation links 742 a, 742 b can be antagonistically driven withrespect to the other link in order to provide a resistive holding motionand a load to the head when it is not moving and to provide anarticulation motion as the head is articulated. The articulation members742 a, 742 b attach to the head at a fixed radius as the head isrotated. Accordingly, the mechanical advantage of the push-and-pull linkchanges as the head is rotated. This change in the mechanical advantagemay be more pronounced with other articulation link drive systems.

In one aspect, the one or more motors 704 a-704 e may comprise a brushedDC motor with a gearbox and mechanical links to a firing member, closuremember, or articulation member. Another example includes electric motors704 a-704 e that operate the movable mechanical elements such as thedisplacement member, articulation links, closure tube, and shaft. Anoutside influence is an unmeasured, unpredictable influence of thingslike tissue, surrounding bodies, and friction on the physical system.Such outside influence can be referred to as drag, which acts inopposition to one of electric motors 704 a-704 e. The outside influence,such as drag, may cause the operation of the physical system to deviatefrom a desired operation of the physical system.

In one aspect, the position sensor 734 may be implemented as an absolutepositioning system. In one aspect, the position sensor 734 may comprisea magnetic rotary absolute positioning system implemented as anAS5055EQFT single-chip magnetic rotary position sensor available fromAustria Microsystems, AG. The position sensor 734 may interface with thecontrol circuit 710 to provide an absolute positioning system. Theposition may include multiple Hall-effect elements located above amagnet and coupled to a CORDIC processor, also known as thedigit-by-digit method and Volder's algorithm, that is provided toimplement a simple and efficient algorithm to calculate hyperbolic andtrigonometric functions that require only addition, subtraction,bitshift, and table lookup operations.

In one aspect, the control circuit 710 may be in communication with oneor more sensors 738. The sensors 738 may be positioned on the endeffector 702 and adapted to operate with the robotic surgical instrument700 to measure the various derived parameters such as the gap distanceversus time, tissue compression versus time, and anvil strain versustime. The sensors 738 may comprise a magnetic sensor, a magnetic fieldsensor, a strain gauge, a load cell, a pressure sensor, a force sensor,a torque sensor, an inductive sensor such as an eddy current sensor, aresistive sensor, a capacitive sensor, an optical sensor, and/or anyother suitable sensor for measuring one or more parameters of the endeffector 702. The sensors 738 may include one or more sensors. Thesensors 738 may be located on the staple cartridge 718 deck to determinetissue location using segmented electrodes. The torque sensors 744 a-744e may be configured to sense force such as firing force, closure force,and/or articulation force, among others. Accordingly, the controlcircuit 710 can sense (1) the closure load experienced by the distalclosure tube and its position, (2) the firing member at the rack and itsposition, (3) what portion of the staple cartridge 718 has tissue on it,and (4) the load and position on both articulation rods.

In one aspect, the one or more sensors 738 may comprise a strain gauge,such as a micro-strain gauge, configured to measure the magnitude of thestrain in the anvil 716 during a clamped condition. The strain gaugeprovides an electrical signal whose amplitude varies with the magnitudeof the strain. The sensors 738 may comprise a pressure sensor configuredto detect a pressure generated by the presence of compressed tissuebetween the anvil 716 and the staple cartridge 718. The sensors 738 maybe configured to detect impedance of a tissue section located betweenthe anvil 716 and the staple cartridge 718 that is indicative of thethickness and/or fullness of tissue located therebetween.

In one aspect, the sensors 738 may be implemented as one or more limitswitches, electromechanical devices, solid-state switches, Hall-effectdevices, magneto-resistive (MR) devices, giant magneto-resistive (GMR)devices, magnetometers, among others. In other implementations, thesensors 738 may be implemented as solid-state switches that operateunder the influence of light, such as optical sensors, IR sensors,ultraviolet sensors, among others. Still, the switches may besolid-state devices such as transistors (e.g., FET, junction FET,MOSFET, bipolar, and the like). In other implementations, the sensors738 may include electrical conductorless switches, ultrasonic switches,accelerometers, and inertial sensors, among others.

In one aspect, the sensors 738 may be configured to measure forcesexerted on the anvil 716 by the closure drive system. For example, oneor more sensors 738 can be at an interaction point between the closuretube and the anvil 716 to detect the closure forces applied by theclosure tube to the anvil 716. The forces exerted on the anvil 716 canbe representative of the tissue compression experienced by the tissuesection captured between the anvil 716 and the staple cartridge 718. Theone or more sensors 738 can be positioned at various interaction pointsalong the closure drive system to detect the closure forces applied tothe anvil 716 by the closure drive system. The one or more sensors 738may be sampled in real time during a clamping operation by the processorof the control circuit 710. The control circuit 710 receives real-timesample measurements to provide and analyze time-based information andassess, in real time, closure forces applied to the anvil 716.

In one aspect, a current sensor 736 can be employed to measure thecurrent drawn by each of the motors 704 a-704 e. The force required toadvance any of the movable mechanical elements such as the I-beam 714corresponds to the current drawn by one of the motors 704 a-704 e. Theforce is converted to a digital signal and provided to the controlcircuit 710. The control circuit 710 can be configured to simulate theresponse of the actual system of the instrument in the software of thecontroller. A displacement member can be actuated to move an I-beam 714in the end effector 702 at or near a target velocity. The roboticsurgical instrument 700 can include a feedback controller, which can beone of any feedback controllers, including, but not limited to a PID, astate feedback, a linear-quadratic (LQR), and/or an adaptive controller,for example. The robotic surgical instrument 700 can include a powersource to convert the signal from the feedback controller into aphysical input such as case voltage, PWM voltage, frequency modulatedvoltage, current, torque, and/or force, for example. Additional detailsare disclosed in U.S. patent application Ser. No. 15/636,829, titledCLOSED LOOP VELOCITY CONTROL TECHNIQUES FOR ROBOTIC SURGICAL INSTRUMENT,filed Jun. 29, 2017, which is herein incorporated by reference in itsentirety.

FIG. 42 illustrates a block diagram of a surgical instrument 750programmed to control the distal translation of a displacement memberaccording to one aspect of this disclosure. In one aspect, the surgicalinstrument 750 is programmed to control the distal translation of adisplacement member such as the I-beam 764. The surgical instrument 750comprises an end effector 752 that may comprise an anvil 766, an I-beam764 (including a sharp cutting edge), and a removable staple cartridge768.

The position, movement, displacement, and/or translation of a lineardisplacement member, such as the I-beam 764, can be measured by anabsolute positioning system, sensor arrangement, and position sensor784. Because the I-beam 764 is coupled to a longitudinally movable drivemember, the position of the I-beam 764 can be determined by measuringthe position of the longitudinally movable drive member employing theposition sensor 784. Accordingly, in the following description, theposition, displacement, and/or translation of the I-beam 764 can beachieved by the position sensor 784 as described herein. A controlcircuit 760 may be programmed to control the translation of thedisplacement member, such as the I-beam 764. The control circuit 760, insome examples, may comprise one or more microcontrollers,microprocessors, or other suitable processors for executing instructionsthat cause the processor or processors to control the displacementmember, e.g., the I-beam 764, in the manner described. In one aspect, atimer/counter 781 provides an output signal, such as the elapsed time ora digital count, to the control circuit 760 to correlate the position ofthe I-beam 764 as determined by the position sensor 784 with the outputof the timer/counter 781 such that the control circuit 760 can determinethe position of the I-beam 764 at a specific time (t) relative to astarting position. The timer/counter 781 may be configured to measureelapsed time, count external events, or time external events.

The control circuit 760 may generate a motor set point signal 772. Themotor set point signal 772 may be provided to a motor controller 758.The motor controller 758 may comprise one or more circuits configured toprovide a motor drive signal 774 to the motor 754 to drive the motor 754as described herein. In some examples, the motor 754 may be a brushed DCelectric motor. For example, the velocity of the motor 754 may beproportional to the motor drive signal 774. In some examples, the motor754 may be a brushless DC electric motor and the motor drive signal 774may comprise a PWM signal provided to one or more stator windings of themotor 754. Also, in some examples, the motor controller 758 may beomitted, and the control circuit 760 may generate the motor drive signal774 directly.

The motor 754 may receive power from an energy source 762. The energysource 762 may be or include a battery, a super capacitor, or any othersuitable energy source. The motor 754 may be mechanically coupled to theI-beam 764 via a transmission 756. The transmission 756 may include oneor more gears or other linkage components to couple the motor 754 to theI-beam 764. A position sensor 784 may sense a position of the I-beam764. The position sensor 784 may be or include any type of sensor thatis capable of generating position data that indicate a position of theI-beam 764. In some examples, the position sensor 784 may include anencoder configured to provide a series of pulses to the control circuit760 as the I-beam 764 translates distally and proximally. The controlcircuit 760 may track the pulses to determine the position of the I-beam764. Other suitable position sensors may be used, including, forexample, a proximity sensor. Other types of position sensors may provideother signals indicating motion of the I-beam 764. Also, in someexamples, the position sensor 784 may be omitted. Where the motor 754 isa stepper motor, the control circuit 760 may track the position of theI-beam 764 by aggregating the number and direction of steps that themotor 754 has been instructed to execute. The position sensor 784 may belocated in the end effector 752 or at any other portion of theinstrument.

The control circuit 760 may be in communication with one or more sensors788. The sensors 788 may be positioned on the end effector 752 andadapted to operate with the surgical instrument 750 to measure thevarious derived parameters such as gap distance versus time, tissuecompression versus time, and anvil strain versus time. The sensors 788may comprise a magnetic sensor, a magnetic field sensor, a strain gauge,a pressure sensor, a force sensor, an inductive sensor such as an eddycurrent sensor, a resistive sensor, a capacitive sensor, an opticalsensor, and/or any other suitable sensor for measuring one or moreparameters of the end effector 752. The sensors 788 may include one ormore sensors.

The one or more sensors 788 may comprise a strain gauge, such as amicro-strain gauge, configured to measure the magnitude of the strain inthe anvil 766 during a clamped condition. The strain gauge provides anelectrical signal whose amplitude varies with the magnitude of thestrain. The sensors 788 may comprise a pressure sensor configured todetect a pressure generated by the presence of compressed tissue betweenthe anvil 766 and the staple cartridge 768. The sensors 788 may beconfigured to detect impedance of a tissue section located between theanvil 766 and the staple cartridge 768 that is indicative of thethickness and/or fullness of tissue located therebetween.

The sensors 788 may be is configured to measure forces exerted on theanvil 766 by a closure drive system. For example, one or more sensors788 can be at an interaction point between a closure tube and the anvil766 to detect the closure forces applied by a closure tube to the anvil766. The forces exerted on the anvil 766 can be representative of thetissue compression experienced by the tissue section captured betweenthe anvil 766 and the staple cartridge 768. The one or more sensors 788can be positioned at various interaction points along the closure drivesystem to detect the closure forces applied to the anvil 766 by theclosure drive system. The one or more sensors 788 may be sampled in realtime during a clamping operation by a processor of the control circuit760. The control circuit 760 receives real-time sample measurements toprovide and analyze time-based information and assess, in real time,closure forces applied to the anvil 766.

A current sensor 786 can be employed to measure the current drawn by themotor 754. The force required to advance the I-beam 764 corresponds tothe current drawn by the motor 754. The force is converted to a digitalsignal and provided to the control circuit 760.

The control circuit 760 can be configured to simulate the response ofthe actual system of the instrument in the software of the controller. Adisplacement member can be actuated to move an I-beam 764 in the endeffector 752 at or near a target velocity. The surgical instrument 750can include a feedback controller, which can be one of any feedbackcontrollers, including, but not limited to a PID, a state feedback, LQR,and/or an adaptive controller, for example. The surgical instrument 750can include a power source to convert the signal from the feedbackcontroller into a physical input such as case voltage, PWM voltage,frequency modulated voltage, current, torque, and/or force, for example.

The actual drive system of the surgical instrument 750 is configured todrive the displacement member, cutting member, or I-beam 764, by abrushed DC motor with gearbox and mechanical links to an articulationand/or knife system. Another example is the electric motor 754 thatoperates the displacement member and the articulation driver, forexample, of an interchangeable shaft assembly. An outside influence isan unmeasured, unpredictable influence of things like tissue,surrounding bodies and friction on the physical system. Such outsideinfluence can be referred to as drag which acts in opposition to theelectric motor 754. The outside influence, such as drag, may cause theoperation of the physical system to deviate from a desired operation ofthe physical system.

Various example aspects are directed to a surgical instrument 750comprising an end effector 752 with motor-driven surgical stapling andcutting implements. For example, a motor 754 may drive a displacementmember distally and proximally along a longitudinal axis of the endeffector 752. The end effector 752 may comprise a pivotable anvil 766and, when configured for use, a staple cartridge 768 positioned oppositethe anvil 766. A clinician may grasp tissue between the anvil 766 andthe staple cartridge 768, as described herein. When ready to use theinstrument 750, the clinician may provide a firing signal, for exampleby depressing a trigger of the instrument 750. In response to the firingsignal, the motor 754 may drive the displacement member distally alongthe longitudinal axis of the end effector 752 from a proximal strokebegin position to a stroke end position distal of the stroke beginposition. As the displacement member translates distally, an I-beam 764with a cutting element positioned at a distal end, may cut the tissuebetween the staple cartridge 768 and the anvil 766.

In various examples, the surgical instrument 750 may comprise a controlcircuit 760 programmed to control the distal translation of thedisplacement member, such as the I-beam 764, for example, based on oneor more tissue conditions. The control circuit 760 may be programmed tosense tissue conditions, such as thickness, either directly orindirectly, as described herein. The control circuit 760 may beprogrammed to select a firing control program based on tissueconditions. A firing control program may describe the distal motion ofthe displacement member. Different firing control programs may beselected to better treat different tissue conditions. For example, whenthicker tissue is present, the control circuit 760 may be programmed totranslate the displacement member at a lower velocity and/or with lowerpower. When thinner tissue is present, the control circuit 760 may beprogrammed to translate the displacement member at a higher velocityand/or with higher power.

In some examples, the control circuit 760 may initially operate themotor 754 in an open loop configuration for a first open loop portion ofa stroke of the displacement member. Based on a response of theinstrument 750 during the open loop portion of the stroke, the controlcircuit 760 may select a firing control program. The response of theinstrument may include, a translation distance of the displacementmember during the open loop portion, a time elapsed during the open loopportion, energy provided to the motor 754 during the open loop portion,a sum of pulse widths of a motor drive signal, etc. After the open loopportion, the control circuit 760 may implement the selected firingcontrol program for a second portion of the displacement member stroke.For example, during the closed loop portion of the stroke, the controlcircuit 760 may modulate the motor 754 based on translation datadescribing a position of the displacement member in a closed loop mannerto translate the displacement member at a constant velocity. Additionaldetails are disclosed in U.S. patent application Ser. No. 15/720,852,titled SYSTEM AND METHODS FOR CONTROLLING A DISPLAY OF A SURGICALINSTRUMENT, filed Sep. 29, 2017, which is herein incorporated byreference in its entirety.

FIG. 43 is a schematic diagram of a surgical instrument 790 configuredto control various functions according to one aspect of this disclosure.In one aspect, the surgical instrument 790 is programmed to controldistal translation of a displacement member such as the I-beam 764. Thesurgical instrument 790 comprises an end effector 792 that may comprisean anvil 766, an I-beam 764, and a removable staple cartridge 768 whichmay be interchanged with an RF cartridge 796 (shown in dashed line).

In one aspect, sensors 788 may be implemented as a limit switch,electromechanical device, solid-state switches, Hall-effect devices, MRdevices, GMR devices, magnetometers, among others. In otherimplementations, the sensors 638 may be solid-state switches thatoperate under the influence of light, such as optical sensors, IRsensors, ultraviolet sensors, among others. Still, the switches may besolid-state devices such as transistors (e.g., FET, junction FET,MOSFET, bipolar, and the like). In other implementations, the sensors788 may include electrical conductorless switches, ultrasonic switches,accelerometers, and inertial sensors, among others.

In one aspect, the position sensor 784 may be implemented as an absolutepositioning system comprising a magnetic rotary absolute positioningsystem implemented as an AS5055EQFT single-chip magnetic rotary positionsensor available from Austria Microsystems, AG. The position sensor 784may interface with the control circuit 760 to provide an absolutepositioning system. The position may include multiple Hall-effectelements located above a magnet and coupled to a CORDIC processor, alsoknown as the digit-by-digit method and Volder's algorithm, that isprovided to implement a simple and efficient algorithm to calculatehyperbolic and trigonometric functions that require only addition,subtraction, bitshift, and table lookup operations.

In one aspect, the I-beam 764 may be implemented as a knife membercomprising a knife body that operably supports a tissue cutting bladethereon and may further include anvil engagement tabs or features andchannel engagement features or a foot. In one aspect, the staplecartridge 768 may be implemented as a standard (mechanical) surgicalfastener cartridge. In one aspect, the RF cartridge 796 may beimplemented as an RF cartridge. These and other sensors arrangements aredescribed in commonly owned U.S. patent application Ser. No. 15/628,175,titled TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICALSTAPLING AND CUTTING INSTRUMENT, filed Jun. 20, 2017, which is hereinincorporated by reference in its entirety.

The position, movement, displacement, and/or translation of a lineardisplacement member, such as the I-beam 764, can be measured by anabsolute positioning system, sensor arrangement, and position sensorrepresented as position sensor 784. Because the I-beam 764 is coupled tothe longitudinally movable drive member, the position of the I-beam 764can be determined by measuring the position of the longitudinallymovable drive member employing the position sensor 784. Accordingly, inthe following description, the position, displacement, and/ortranslation of the I-beam 764 can be achieved by the position sensor 784as described herein. A control circuit 760 may be programmed to controlthe translation of the displacement member, such as the I-beam 764, asdescribed herein. The control circuit 760, in some examples, maycomprise one or more microcontrollers, microprocessors, or othersuitable processors for executing instructions that cause the processoror processors to control the displacement member, e.g., the I-beam 764,in the manner described. In one aspect, a timer/counter 781 provides anoutput signal, such as the elapsed time or a digital count, to thecontrol circuit 760 to correlate the position of the I-beam 764 asdetermined by the position sensor 784 with the output of thetimer/counter 781 such that the control circuit 760 can determine theposition of the I-beam 764 at a specific time (t) relative to a startingposition. The timer/counter 781 may be configured to measure elapsedtime, count external events, or time external events.

The control circuit 760 may generate a motor set point signal 772. Themotor set point signal 772 may be provided to a motor controller 758.The motor controller 758 may comprise one or more circuits configured toprovide a motor drive signal 774 to the motor 754 to drive the motor 754as described herein. In some examples, the motor 754 may be a brushed DCelectric motor. For example, the velocity of the motor 754 may beproportional to the motor drive signal 774. In some examples, the motor754 may be a brushless DC electric motor and the motor drive signal 774may comprise a PWM signal provided to one or more stator windings of themotor 754. Also, in some examples, the motor controller 758 may beomitted, and the control circuit 760 may generate the motor drive signal774 directly.

The motor 754 may receive power from an energy source 762. The energysource 762 may be or include a battery, a super capacitor, or any othersuitable energy source. The motor 754 may be mechanically coupled to theI-beam 764 via a transmission 756. The transmission 756 may include oneor more gears or other linkage components to couple the motor 754 to theI-beam 764. A position sensor 784 may sense a position of the I-beam764. The position sensor 784 may be or include any type of sensor thatis capable of generating position data that indicate a position of theI-beam 764. In some examples, the position sensor 784 may include anencoder configured to provide a series of pulses to the control circuit760 as the I-beam 764 translates distally and proximally. The controlcircuit 760 may track the pulses to determine the position of the I-beam764. Other suitable position sensors may be used, including, forexample, a proximity sensor. Other types of position sensors may provideother signals indicating motion of the I-beam 764. Also, in someexamples, the position sensor 784 may be omitted. Where the motor 754 isa stepper motor, the control circuit 760 may track the position of theI-beam 764 by aggregating the number and direction of steps that themotor has been instructed to execute. The position sensor 784 may belocated in the end effector 792 or at any other portion of theinstrument.

The control circuit 760 may be in communication with one or more sensors788. The sensors 788 may be positioned on the end effector 792 andadapted to operate with the surgical instrument 790 to measure thevarious derived parameters such as gap distance versus time, tissuecompression versus time, and anvil strain versus time. The sensors 788may comprise a magnetic sensor, a magnetic field sensor, a strain gauge,a pressure sensor, a force sensor, an inductive sensor such as an eddycurrent sensor, a resistive sensor, a capacitive sensor, an opticalsensor, and/or any other suitable sensor for measuring one or moreparameters of the end effector 792. The sensors 788 may include one ormore sensors.

The one or more sensors 788 may comprise a strain gauge, such as amicro-strain gauge, configured to measure the magnitude of the strain inthe anvil 766 during a clamped condition. The strain gauge provides anelectrical signal whose amplitude varies with the magnitude of thestrain. The sensors 788 may comprise a pressure sensor configured todetect a pressure generated by the presence of compressed tissue betweenthe anvil 766 and the staple cartridge 768. The sensors 788 may beconfigured to detect impedance of a tissue section located between theanvil 766 and the staple cartridge 768 that is indicative of thethickness and/or fullness of tissue located therebetween.

The sensors 788 may be is configured to measure forces exerted on theanvil 766 by the closure drive system. For example, one or more sensors788 can be at an interaction point between a closure tube and the anvil766 to detect the closure forces applied by a closure tube to the anvil766. The forces exerted on the anvil 766 can be representative of thetissue compression experienced by the tissue section captured betweenthe anvil 766 and the staple cartridge 768. The one or more sensors 788can be positioned at various interaction points along the closure drivesystem to detect the closure forces applied to the anvil 766 by theclosure drive system. The one or more sensors 788 may be sampled in realtime during a clamping operation by a processor portion of the controlcircuit 760. The control circuit 760 receives real-time samplemeasurements to provide and analyze time-based information and assess,in real time, closure forces applied to the anvil 766.

A current sensor 786 can be employed to measure the current drawn by themotor 754. The force required to advance the I-beam 764 corresponds tothe current drawn by the motor 754. The force is converted to a digitalsignal and provided to the control circuit 760.

An RF energy source 794 is coupled to the end effector 792 and isapplied to the RF cartridge 796 when the RF cartridge 796 is loaded inthe end effector 792 in place of the staple cartridge 768. The controlcircuit 760 controls the delivery of the RF energy to the RF cartridge796.

Additional details are disclosed in U.S. patent application Ser. No.15/636,096, titled SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE ANDRADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME, filed Jun. 28,2017, which is herein incorporated by reference in its entirety.

Generator Hardware

FIG. 44 is a simplified block diagram of a generator 800 configured toprovide inductorless tuning, among other benefits. Additional details ofthe generator 800 are described in U.S. Pat. No. 9,060,775, titledSURGICAL GENERATOR FOR ULTRASONIC AND ELECTROSURGICAL DEVICES, whichissued on Jun. 23, 2015, which is herein incorporated by reference inits entirety. The generator 800 may comprise a patient isolated stage802 in communication with a non-isolated stage 804 via a powertransformer 806. A secondary winding 808 of the power transformer 806 iscontained in the isolated stage 802 and may comprise a tappedconfiguration (e.g., a center-tapped or a non-center-tappedconfiguration) to define drive signal outputs 810 a, 810 b, 810 c fordelivering drive signals to different surgical instruments, such as, forexample, an ultrasonic surgical instrument, an RF electrosurgicalinstrument, and a multifunction surgical instrument which includesultrasonic and RF energy modes that can be delivered alone orsimultaneously. In particular, drive signal outputs 810 a, 810 c mayoutput an ultrasonic drive signal (e.g., a 420V root-mean-square (RMS)drive signal) to an ultrasonic surgical instrument, and drive signaloutputs 810 b, 810 c may output an RF electrosurgical drive signal(e.g., a 100V RMS drive signal) to an RF electrosurgical instrument,with the drive signal output 810 b corresponding to the center tap ofthe power transformer 806.

In certain forms, the ultrasonic and electrosurgical drive signals maybe provided simultaneously to distinct surgical instruments and/or to asingle surgical instrument, such as the multifunction surgicalinstrument, having the capability to deliver both ultrasonic andelectrosurgical energy to tissue. It will be appreciated that theelectrosurgical signal, provided either to a dedicated electrosurgicalinstrument and/or to a combined multifunction ultrasonic/electrosurgicalinstrument may be either a therapeutic or sub-therapeutic level signalwhere the sub-therapeutic signal can be used, for example, to monitortissue or instrument conditions and provide feedback to the generator.For example, the ultrasonic and RF signals can be delivered separatelyor simultaneously from a generator with a single output port in order toprovide the desired output signal to the surgical instrument, as will bediscussed in more detail below. Accordingly, the generator can combinethe ultrasonic and electrosurgical RF energies and deliver the combinedenergies to the multifunction ultrasonic/electrosurgical instrument.Bipolar electrodes can be placed on one or both jaws of the endeffector. One jaw may be driven by ultrasonic energy in addition toelectrosurgical RF energy, working simultaneously. The ultrasonic energymay be employed to dissect tissue, while the electrosurgical RF energymay be employed for vessel sealing.

The non-isolated stage 804 may comprise a power amplifier 812 having anoutput connected to a primary winding 814 of the power transformer 806.In certain forms, the power amplifier 812 may comprise a push-pullamplifier. For example, the non-isolated stage 804 may further comprisea logic device 816 for supplying a digital output to a digital-to-analogconverter (DAC) circuit 818, which in turn supplies a correspondinganalog signal to an input of the power amplifier 812. In certain forms,the logic device 816 may comprise a programmable gate array (PGA), aFPGA, programmable logic device (PLD), among other logic circuits, forexample. The logic device 816, by virtue of controlling the input of thepower amplifier 812 via the DAC circuit 818, may therefore control anyof a number of parameters (e.g., frequency, waveform shape, waveformamplitude) of drive signals appearing at the drive signal outputs 810 a,810 b, 810 c. In certain forms and as discussed below, the logic device816, in conjunction with a processor (e.g., a DSP discussed below), mayimplement a number of DSP-based and/or other control algorithms tocontrol parameters of the drive signals output by the generator 800.

Power may be supplied to a power rail of the power amplifier 812 by aswitch-mode regulator 820, e.g., a power converter. In certain forms,the switch-mode regulator 820 may comprise an adjustable buck regulator,for example. The non-isolated stage 804 may further comprise a firstprocessor 822, which in one form may comprise a DSP processor such as anAnalog Devices ADSP-21469 SHARC DSP, available from Analog Devices,Norwood, Mass., for example, although in various forms any suitableprocessor may be employed. In certain forms the DSP processor 822 maycontrol the operation of the switch-mode regulator 820 responsive tovoltage feedback data received from the power amplifier 812 by the DSPprocessor 822 via an ADC circuit 824. In one form, for example, the DSPprocessor 822 may receive as input, via the ADC circuit 824, thewaveform envelope of a signal (e.g., an RF signal) being amplified bythe power amplifier 812. The DSP processor 822 may then control theswitch-mode regulator 820 (e.g., via a PWM output) such that the railvoltage supplied to the power amplifier 812 tracks the waveform envelopeof the amplified signal. By dynamically modulating the rail voltage ofthe power amplifier 812 based on the waveform envelope, the efficiencyof the power amplifier 812 may be significantly improved relative to afixed rail voltage amplifier schemes.

In certain forms, the logic device 816, in conjunction with the DSPprocessor 822, may implement a digital synthesis circuit such as adirect digital synthesizer control scheme to control the waveform shape,frequency, and/or amplitude of drive signals output by the generator800. In one form, for example, the logic device 816 may implement a DDScontrol algorithm by recalling waveform samples stored in a dynamicallyupdated lookup table (LUT), such as a RAM LUT, which may be embedded inan FPGA. This control algorithm is particularly useful for ultrasonicapplications in which an ultrasonic transducer, such as an ultrasonictransducer, may be driven by a clean sinusoidal current at its resonantfrequency. Because other frequencies may excite parasitic resonances,minimizing or reducing the total distortion of the motional branchcurrent may correspondingly minimize or reduce undesirable resonanceeffects. Because the waveform shape of a drive signal output by thegenerator 800 is impacted by various sources of distortion present inthe output drive circuit (e.g., the power transformer 806, the poweramplifier 812), voltage and current feedback data based on the drivesignal may be input into an algorithm, such as an error controlalgorithm implemented by the DSP processor 822, which compensates fordistortion by suitably pre-distorting or modifying the waveform samplesstored in the LUT on a dynamic, ongoing basis (e.g., in real time). Inone form, the amount or degree of pre-distortion applied to the LUTsamples may be based on the error between a computed motional branchcurrent and a desired current waveform shape, with the error beingdetermined on a sample-by-sample basis. In this way, the pre-distortedLUT samples, when processed through the drive circuit, may result in amotional branch drive signal having the desired waveform shape (e.g.,sinusoidal) for optimally driving the ultrasonic transducer. In suchforms, the LUT waveform samples will therefore not represent the desiredwaveform shape of the drive signal, but rather the waveform shape thatis required to ultimately produce the desired waveform shape of themotional branch drive signal when distortion effects are taken intoaccount.

The non-isolated stage 804 may further comprise a first ADC circuit 826and a second ADC circuit 828 coupled to the output of the powertransformer 806 via respective isolation transformers 830, 832 forrespectively sampling the voltage and current of drive signals output bythe generator 800. In certain forms, the ADC circuits 826, 828 may beconfigured to sample at high speeds (e.g., 80 mega samples per second(MSPS)) to enable oversampling of the drive signals. In one form, forexample, the sampling speed of the ADC circuits 826, 828 may enableapproximately 200× (depending on frequency) oversampling of the drivesignals. In certain forms, the sampling operations of the ADC circuit826, 828 may be performed by a single ADC circuit receiving inputvoltage and current signals via a two-way multiplexer. The use ofhigh-speed sampling in forms of the generator 800 may enable, amongother things, calculation of the complex current flowing through themotional branch (which may be used in certain forms to implementDDS-based waveform shape control described above), accurate digitalfiltering of the sampled signals, and calculation of real powerconsumption with a high degree of precision. Voltage and currentfeedback data output by the ADC circuits 826, 828 may be received andprocessed (e.g., first-in-first-out (FIFO) buffer, multiplexer) by thelogic device 816 and stored in data memory for subsequent retrieval by,for example, the DSP processor 822. As noted above, voltage and currentfeedback data may be used as input to an algorithm for pre-distorting ormodifying LUT waveform samples on a dynamic and ongoing basis. Incertain forms, this may require each stored voltage and current feedbackdata pair to be indexed based on, or otherwise associated with, acorresponding LUT sample that was output by the logic device 816 whenthe voltage and current feedback data pair was acquired. Synchronizationof the LUT samples and the voltage and current feedback data in thismanner contributes to the correct timing and stability of thepre-distortion algorithm.

In certain forms, the voltage and current feedback data may be used tocontrol the frequency and/or amplitude (e.g., current amplitude) of thedrive signals. In one form, for example, voltage and current feedbackdata may be used to determine impedance phase. The frequency of thedrive signal may then be controlled to minimize or reduce the differencebetween the determined impedance phase and an impedance phase setpoint(e.g., 0°), thereby minimizing or reducing the effects of harmonicdistortion and correspondingly enhancing impedance phase measurementaccuracy. The determination of phase impedance and a frequency controlsignal may be implemented in the DSP processor 822, for example, withthe frequency control signal being supplied as input to a DDS controlalgorithm implemented by the logic device 816.

In another form, for example, the current feedback data may be monitoredin order to maintain the current amplitude of the drive signal at acurrent amplitude setpoint. The current amplitude setpoint may bespecified directly or determined indirectly based on specified voltageamplitude and power setpoints. In certain forms, control of the currentamplitude may be implemented by control algorithm, such as, for example,a proportional-integral-derivative (PID) control algorithm, in the DSPprocessor 822. Variables controlled by the control algorithm to suitablycontrol the current amplitude of the drive signal may include, forexample, the scaling of the LUT waveform samples stored in the logicdevice 816 and/or the full-scale output voltage of the DAC circuit 818(which supplies the input to the power amplifier 812) via a DAC circuit834.

The non-isolated stage 804 may further comprise a second processor 836for providing, among other things user interface (UI) functionality. Inone form, the UI processor 836 may comprise an Atmel AT91SAM9263processor having an ARM 926EJ-S core, available from Atmel Corporation,San Jose, Calif., for example. Examples of UI functionality supported bythe UI processor 836 may include audible and visual user feedback,communication with peripheral devices (e.g., via a USB interface),communication with a foot switch, communication with an input device(e.g., a touch screen display) and communication with an output device(e.g., a speaker). The UI processor 836 may communicate with the DSPprocessor 822 and the logic device 816 (e.g., via SPI buses). Althoughthe UI processor 836 may primarily support UI functionality, it may alsocoordinate with the DSP processor 822 to implement hazard mitigation incertain forms. For example, the UI processor 836 may be programmed tomonitor various aspects of user input and/or other inputs (e.g., touchscreen inputs, foot switch inputs, temperature sensor inputs) and maydisable the drive output of the generator 800 when an erroneouscondition is detected.

In certain forms, both the DSP processor 822 and the UI processor 836,for example, may determine and monitor the operating state of thegenerator 800. For the DSP processor 822, the operating state of thegenerator 800 may dictate, for example, which control and/or diagnosticprocesses are implemented by the DSP processor 822. For the UI processor836, the operating state of the generator 800 may dictate, for example,which elements of a UI (e.g., display screens, sounds) are presented toa user. The respective DSP and UI processors 822, 836 may independentlymaintain the current operating state of the generator 800 and recognizeand evaluate possible transitions out of the current operating state.The DSP processor 822 may function as the master in this relationshipand determine when transitions between operating states are to occur.The UI processor 836 may be aware of valid transitions between operatingstates and may confirm if a particular transition is appropriate. Forexample, when the DSP processor 822 instructs the UI processor 836 totransition to a specific state, the UI processor 836 may verify thatrequested transition is valid. In the event that a requested transitionbetween states is determined to be invalid by the UI processor 836, theUI processor 836 may cause the generator 800 to enter a failure mode.

The non-isolated stage 804 may further comprise a controller 838 formonitoring input devices (e.g., a capacitive touch sensor used forturning the generator 800 on and off, a capacitive touch screen). Incertain forms, the controller 838 may comprise at least one processorand/or other controller device in communication with the UI processor836. In one form, for example, the controller 838 may comprise aprocessor (e.g., a Meg168 8-bit controller available from Atmel)configured to monitor user input provided via one or more capacitivetouch sensors. In one form, the controller 838 may comprise a touchscreen controller (e.g., a QT5480 touch screen controller available fromAtmel) to control and manage the acquisition of touch data from acapacitive touch screen.

In certain forms, when the generator 800 is in a “power off” state, thecontroller 838 may continue to receive operating power (e.g., via a linefrom a power supply of the generator 800, such as the power supply 854discussed below). In this way, the controller 838 may continue tomonitor an input device (e.g., a capacitive touch sensor located on afront panel of the generator 800) for turning the generator 800 on andoff. When the generator 800 is in the power off state, the controller838 may wake the power supply (e.g., enable operation of one or moreDC/DC voltage converters 856 of the power supply 854) if activation ofthe “on/off” input device by a user is detected. The controller 838 maytherefore initiate a sequence for transitioning the generator 800 to a“power on” state. Conversely, the controller 838 may initiate a sequencefor transitioning the generator 800 to the power off state if activationof the “on/off” input device is detected when the generator 800 is inthe power on state. In certain forms, for example, the controller 838may report activation of the “on/off” input device to the UI processor836, which in turn implements the necessary process sequence fortransitioning the generator 800 to the power off state. In such forms,the controller 838 may have no independent ability for causing theremoval of power from the generator 800 after its power on state hasbeen established.

In certain forms, the controller 838 may cause the generator 800 toprovide audible or other sensory feedback for alerting the user that apower on or power off sequence has been initiated. Such an alert may beprovided at the beginning of a power on or power off sequence and priorto the commencement of other processes associated with the sequence.

In certain forms, the isolated stage 802 may comprise an instrumentinterface circuit 840 to, for example, provide a communication interfacebetween a control circuit of a surgical instrument (e.g., a controlcircuit comprising handpiece switches) and components of thenon-isolated stage 804, such as, for example, the logic device 816, theDSP processor 822, and/or the UI processor 836. The instrument interfacecircuit 840 may exchange information with components of the non-isolatedstage 804 via a communication link that maintains a suitable degree ofelectrical isolation between the isolated and non-isolated stages 802,804, such as, for example, an IR-based communication link. Power may besupplied to the instrument interface circuit 840 using, for example, alow-dropout voltage regulator powered by an isolation transformer drivenfrom the non-isolated stage 804.

In one form, the instrument interface circuit 840 may comprise a logiccircuit 842 (e.g., logic circuit, programmable logic circuit, PGA, FPGA,PLD) in communication with a signal conditioning circuit 844. The signalconditioning circuit 844 may be configured to receive a periodic signalfrom the logic circuit 842 (e.g., a 2 kHz square wave) to generate abipolar interrogation signal having an identical frequency. Theinterrogation signal may be generated, for example, using a bipolarcurrent source fed by a differential amplifier. The interrogation signalmay be communicated to a surgical instrument control circuit (e.g., byusing a conductive pair in a cable that connects the generator 800 tothe surgical instrument) and monitored to determine a state orconfiguration of the control circuit. The control circuit may comprise anumber of switches, resistors, and/or diodes to modify one or morecharacteristics (e.g., amplitude, rectification) of the interrogationsignal such that a state or configuration of the control circuit isuniquely discernable based on the one or more characteristics. In oneform, for example, the signal conditioning circuit 844 may comprise anADC circuit for generating samples of a voltage signal appearing acrossinputs of the control circuit resulting from passage of interrogationsignal therethrough. The logic circuit 842 (or a component of thenon-isolated stage 804) may then determine the state or configuration ofthe control circuit based on the ADC circuit samples.

In one form, the instrument interface circuit 840 may comprise a firstdata circuit interface 846 to enable information exchange between thelogic circuit 842 (or other element of the instrument interface circuit840) and a first data circuit disposed in or otherwise associated with asurgical instrument. In certain forms, for example, a first data circuitmay be disposed in a cable integrally attached to a surgical instrumenthandpiece or in an adaptor for interfacing a specific surgicalinstrument type or model with the generator 800. The first data circuitmay be implemented in any suitable manner and may communicate with thegenerator according to any suitable protocol, including, for example, asdescribed herein with respect to the first data circuit. In certainforms, the first data circuit may comprise a non-volatile storagedevice, such as an EEPROM device. In certain forms, the first datacircuit interface 846 may be implemented separately from the logiccircuit 842 and comprise suitable circuitry (e.g., discrete logicdevices, a processor) to enable communication between the logic circuit842 and the first data circuit. In other forms, the first data circuitinterface 846 may be integral with the logic circuit 842.

In certain forms, the first data circuit may store informationpertaining to the particular surgical instrument with which it isassociated. Such information may include, for example, a model number, aserial number, a number of operations in which the surgical instrumenthas been used, and/or any other type of information. This informationmay be read by the instrument interface circuit 840 (e.g., by the logiccircuit 842), transferred to a component of the non-isolated stage 804(e.g., to logic device 816, DSP processor 822, and/or UI processor 836)for presentation to a user via an output device and/or for controlling afunction or operation of the generator 800. Additionally, any type ofinformation may be communicated to the first data circuit for storagetherein via the first data circuit interface 846 (e.g., using the logiccircuit 842). Such information may comprise, for example, an updatednumber of operations in which the surgical instrument has been usedand/or dates and/or times of its usage.

As discussed previously, a surgical instrument may be detachable from ahandpiece (e.g., the multifunction surgical instrument may be detachablefrom the handpiece) to promote instrument interchangeability and/ordisposability. In such cases, conventional generators may be limited intheir ability to recognize particular instrument configurations beingused and to optimize control and diagnostic processes accordingly. Theaddition of readable data circuits to surgical instruments to addressthis issue is problematic from a compatibility standpoint, however. Forexample, designing a surgical instrument to remain backwardly compatiblewith generators that lack the requisite data reading functionality maybe impractical due to, for example, differing signal schemes, designcomplexity, and cost. Forms of instruments discussed herein addressthese concerns by using data circuits that may be implemented inexisting surgical instruments economically and with minimal designchanges to preserve compatibility of the surgical instruments withcurrent generator platforms.

Additionally, forms of the generator 800 may enable communication withinstrument-based data circuits. For example, the generator 800 may beconfigured to communicate with a second data circuit contained in aninstrument (e.g., the multifunction surgical instrument). In some forms,the second data circuit may be implemented in a many similar to that ofthe first data circuit described herein. The instrument interfacecircuit 840 may comprise a second data circuit interface 848 to enablethis communication. In one form, the second data circuit interface 848may comprise a tri-state digital interface, although other interfacesmay also be used. In certain forms, the second data circuit maygenerally be any circuit for transmitting and/or receiving data. In oneform, for example, the second data circuit may store informationpertaining to the particular surgical instrument with which it isassociated. Such information may include, for example, a model number, aserial number, a number of operations in which the surgical instrumenthas been used, and/or any other type of information.

In some forms, the second data circuit may store information about theelectrical and/or ultrasonic properties of an associated ultrasonictransducer, end effector, or ultrasonic drive system. For example, thefirst data circuit may indicate a burn-in frequency slope, as describedherein. Additionally or alternatively, any type of information may becommunicated to second data circuit for storage therein via the seconddata circuit interface 848 (e.g., using the logic circuit 842). Suchinformation may comprise, for example, an updated number of operationsin which the instrument has been used and/or dates and/or times of itsusage. In certain forms, the second data circuit may transmit dataacquired by one or more sensors (e.g., an instrument-based temperaturesensor). In certain forms, the second data circuit may receive data fromthe generator 800 and provide an indication to a user (e.g., a lightemitting diode indication or other visible indication) based on thereceived data.

In certain forms, the second data circuit and the second data circuitinterface 848 may be configured such that communication between thelogic circuit 842 and the second data circuit can be effected withoutthe need to provide additional conductors for this purpose (e.g.,dedicated conductors of a cable connecting a handpiece to the generator800). In one form, for example, information may be communicated to andfrom the second data circuit using a one-wire bus communication schemeimplemented on existing cabling, such as one of the conductors usedtransmit interrogation signals from the signal conditioning circuit 844to a control circuit in a handpiece. In this way, design changes ormodifications to the surgical instrument that might otherwise benecessary are minimized or reduced. Moreover, because different types ofcommunications implemented over a common physical channel can befrequency-band separated, the presence of a second data circuit may be“invisible” to generators that do not have the requisite data readingfunctionality, thus enabling backward compatibility of the surgicalinstrument.

In certain forms, the isolated stage 802 may comprise at least oneblocking capacitor 850-1 connected to the drive signal output 810 b toprevent passage of DC current to a patient. A single blocking capacitormay be required to comply with medical regulations or standards, forexample. While failure in single-capacitor designs is relativelyuncommon, such failure may nonetheless have negative consequences. Inone form, a second blocking capacitor 850-2 may be provided in serieswith the blocking capacitor 850-1, with current leakage from a pointbetween the blocking capacitors 850-1, 850-2 being monitored by, forexample, an ADC circuit 852 for sampling a voltage induced by leakagecurrent. The samples may be received by the logic circuit 842, forexample. Based changes in the leakage current (as indicated by thevoltage samples), the generator 800 may determine when at least one ofthe blocking capacitors 850-1, 850-2 has failed, thus providing abenefit over single-capacitor designs having a single point of failure.

In certain forms, the non-isolated stage 804 may comprise a power supply854 for delivering DC power at a suitable voltage and current. The powersupply may comprise, for example, a 400 W power supply for delivering a48 VDC system voltage. The power supply 854 may further comprise one ormore DC/DC voltage converters 856 for receiving the output of the powersupply to generate DC outputs at the voltages and currents required bythe various components of the generator 800. As discussed above inconnection with the controller 838, one or more of the DC/DC voltageconverters 856 may receive an input from the controller 838 whenactivation of the “on/off” input device by a user is detected by thecontroller 838 to enable operation of, or wake, the DC/DC voltageconverters 856.

FIG. 45 illustrates an example of a generator 900, which is one form ofthe generator 800 (FIG. 44). The generator 900 is configured to delivermultiple energy modalities to a surgical instrument. The generator 900provides RF and ultrasonic signals for delivering energy to a surgicalinstrument either independently or simultaneously. The RF and ultrasonicsignals may be provided alone or in combination and may be providedsimultaneously. As noted above, at least one generator output candeliver multiple energy modalities (e.g., ultrasonic, bipolar ormonopolar RF, irreversible and/or reversible electroporation, and/ormicrowave energy, among others) through a single port, and these signalscan be delivered separately or simultaneously to the end effector totreat tissue.

The generator 900 comprises a processor 902 coupled to a waveformgenerator 904. The processor 902 and waveform generator 904 areconfigured to generate a variety of signal waveforms based oninformation stored in a memory coupled to the processor 902, not shownfor clarity of disclosure. The digital information associated with awaveform is provided to the waveform generator 904 which includes one ormore DAC circuits to convert the digital input into an analog output.The analog output is fed to an amplifier 1106 for signal conditioningand amplification. The conditioned and amplified output of the amplifier906 is coupled to a power transformer 908. The signals are coupledacross the power transformer 908 to the secondary side, which is in thepatient isolation side. A first signal of a first energy modality isprovided to the surgical instrument between the terminals labeledENERGY1 and RETURN. A second signal of a second energy modality iscoupled across a capacitor 910 and is provided to the surgicalinstrument between the terminals labeled ENERGY2 and RETURN. It will beappreciated that more than two energy modalities may be output and thusthe subscript “n” may be used to designate that up to n ENERGYnterminals may be provided, where n is a positive integer greater than 1.It also will be appreciated that up to “n” return paths RETURNn may beprovided without departing from the scope of the present disclosure.

A first voltage sensing circuit 912 is coupled across the terminalslabeled ENERGY1 and the RETURN path to measure the output voltagetherebetween. A second voltage sensing circuit 924 is coupled across theterminals labeled ENERGY2 and the RETURN path to measure the outputvoltage therebetween. A current sensing circuit 914 is disposed inseries with the RETURN leg of the secondary side of the powertransformer 908 as shown to measure the output current for either energymodality. If different return paths are provided for each energymodality, then a separate current sensing circuit should be provided ineach return leg. The outputs of the first and second voltage sensingcircuits 912, 924 are provided to respective isolation transformers 916,922 and the output of the current sensing circuit 914 is provided toanother isolation transformer 918. The outputs of the isolationtransformers 916, 928, 922 in the on the primary side of the powertransformer 908 (non-patient isolated side) are provided to a one ormore ADC circuit 926. The digitized output of the ADC circuit 926 isprovided to the processor 902 for further processing and computation.The output voltages and output current feedback information can beemployed to adjust the output voltage and current provided to thesurgical instrument and to compute output impedance, among otherparameters. Input/output communications between the processor 902 andpatient isolated circuits is provided through an interface circuit 920.Sensors also may be in electrical communication with the processor 902by way of the interface circuit 920.

In one aspect, the impedance may be determined by the processor 902 bydividing the output of either the first voltage sensing circuit 912coupled across the terminals labeled ENERGY1/RETURN or the secondvoltage sensing circuit 924 coupled across the terminals labeledENERGY2/RETURN by the output of the current sensing circuit 914 disposedin series with the RETURN leg of the secondary side of the powertransformer 908. The outputs of the first and second voltage sensingcircuits 912, 924 are provided to separate isolations transformers 916,922 and the output of the current sensing circuit 914 is provided toanother isolation transformer 916. The digitized voltage and currentsensing measurements from the ADC circuit 926 are provided the processor902 for computing impedance. As an example, the first energy modalityENERGY1 may be ultrasonic energy and the second energy modality ENERGY2may be RF energy. Nevertheless, in addition to ultrasonic and bipolar ormonopolar RF energy modalities, other energy modalities includeirreversible and/or reversible electroporation and/or microwave energy,among others. Also, although the example illustrated in FIG. 45 shows asingle return path RETURN may be provided for two or more energymodalities, in other aspects, multiple return paths RETURNn may beprovided for each energy modality ENERGYn. Thus, as described herein,the ultrasonic transducer impedance may be measured by dividing theoutput of the first voltage sensing circuit 912 by the current sensingcircuit 914 and the tissue impedance may be measured by dividing theoutput of the second voltage sensing circuit 924 by the current sensingcircuit 914.

As shown in FIG. 45, the generator 900 comprising at least one outputport can include a power transformer 908 with a single output and withmultiple taps to provide power in the form of one or more energymodalities, such as ultrasonic, bipolar or monopolar RF, irreversibleand/or reversible electroporation, and/or microwave energy, amongothers, for example, to the end effector depending on the type oftreatment of tissue being performed. For example, the generator 900 candeliver energy with higher voltage and lower current to drive anultrasonic transducer, with lower voltage and higher current to drive RFelectrodes for sealing tissue, or with a coagulation waveform for spotcoagulation using either monopolar or bipolar RF electrosurgicalelectrodes. The output waveform from the generator 900 can be steered,switched, or filtered to provide the frequency to the end effector ofthe surgical instrument. The connection of an ultrasonic transducer tothe generator 900 output would be preferably located between the outputlabeled ENERGY1 and RETURN as shown in FIG. 45. In one example, aconnection of RF bipolar electrodes to the generator 900 output would bepreferably located between the output labeled ENERGY2 and RETURN. In thecase of monopolar output, the preferred connections would be activeelectrode (e.g., pencil or other probe) to the ENERGY2 output and asuitable return pad connected to the RETURN output.

Additional details are disclosed in U.S. Patent Application PublicationNo. 2017/0086914, titled TECHNIQUES FOR OPERATING GENERATOR FORDIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICALINSTRUMENTS, which published on Mar. 30, 2017, which is hereinincorporated by reference in its entirety.

As used throughout this description, the term “wireless” and itsderivatives may be used to describe circuits, devices, systems, methods,techniques, communications channels, etc., that may communicate datathrough the use of modulated electromagnetic radiation through anon-solid medium. The term does not imply that the associated devices donot contain any wires, although in some aspects they might not. Thecommunication module may implement any of a number of wireless or wiredcommunication standards or protocols, including but not limited to Wi-Fi(IEEE 802.11 family), WiMAX (IEEE 802.16 family), IEEE 802.20, long termevolution (LTE), Ev-DO, HSPA+, HSDPA+, HSUPA+, EDGE, GSM, GPRS, CDMA,TDMA, DECT, Bluetooth, Ethernet derivatives thereof, as well as anyother wireless and wired protocols that are designated as 3G, 4G, 5G,and beyond. The computing module may include a plurality ofcommunication modules. For instance, a first communication module may bededicated to shorter range wireless communications such as Wi-Fi andBluetooth and a second communication module may be dedicated to longerrange wireless communications such as GPS, EDGE, GPRS, CDMA, WiMAX, LTE,Ev-DO, and others.

As used herein a processor or processing unit is an electronic circuitwhich performs operations on some external data source, usually memoryor some other data stream. The term is used herein to refer to thecentral processor (central processing unit) in a system or computersystems (especially systems on a chip (SoCs)) that combine a number ofspecialized “processors.”

As used herein, a system on a chip or system on chip (SoC or SOC) is anintegrated circuit (also known as an “IC” or “chip”) that integrates allcomponents of a computer or other electronic systems. It may containdigital, analog, mixed-signal, and often radio-frequency functions—allon a single substrate. A SoC integrates a microcontroller (ormicroprocessor) with advanced peripherals like graphics processing unit(GPU), Wi-Fi module, or coprocessor. A SoC may or may not containbuilt-in memory.

As used herein, a microcontroller or controller is a system thatintegrates a microprocessor with peripheral circuits and memory. Amicrocontroller (or MCU for microcontroller unit) may be implemented asa small computer on a single integrated circuit. It may be similar to aSoC; an SoC may include a microcontroller as one of its components. Amicrocontroller may contain one or more core processing units (CPUs)along with memory and programmable input/output peripherals. Programmemory in the form of Ferroelectric RAM, NOR flash or OTP ROM is alsooften included on chip, as well as a small amount of RAM.Microcontrollers may be employed for embedded applications, in contrastto the microprocessors used in personal computers or other generalpurpose applications consisting of various discrete chips.

As used herein, the term controller or microcontroller may be astand-alone IC or chip device that interfaces with a peripheral device.This may be a link between two parts of a computer or a controller on anexternal device that manages the operation of (and connection with) thatdevice.

Any of the processors or microcontrollers described herein, may beimplemented by any single core or multicore processor such as thoseknown under the trade name ARM Cortex by Texas Instruments. In oneaspect, the processor may be an LM4F230H5QR ARM Cortex-M4F ProcessorCore, available from Texas Instruments, for example, comprising on-chipmemory of 256 KB single-cycle flash memory, or other non-volatilememory, up to 40 MHz, a prefetch buffer to improve performance above 40MHz, a 32 KB single-cycle serial random access memory (SRAM), internalread-only memory (ROM) loaded with StellarisWare® software, 2 KBelectrically erasable programmable read-only memory (EEPROM), one ormore pulse width modulation (PWM) modules, one or more quadratureencoder inputs (QEI) analog, one or more 12-bit Analog-to-DigitalConverters (ADC) with 12 analog input channels, details of which areavailable for the product datasheet.

In one aspect, the processor may comprise a safety controller comprisingtwo controller-based families such as TMS570 and RM4x known under thetrade name Hercules ARM Cortex R4, also by Texas Instruments. The safetycontroller may be configured specifically for IEC 61508 and ISO 26262safety critical applications, among others, to provide advancedintegrated safety features while delivering scalable performance,connectivity, and memory options.

Modular devices include the modules (as described in connection withFIGS. 3 and 9, for example) that are receivable within a surgical huband the surgical devices or instruments that can be connected to thevarious modules in order to connect or pair with the correspondingsurgical hub. The modular devices include, for example, intelligentsurgical instruments, medical imaging devices, suction/irrigationdevices, smoke evacuators, energy generators, ventilators, insufflators,and displays. The modular devices described herein can be controlled bycontrol algorithms. The control algorithms can be executed on themodular device itself, on the surgical hub to which the particularmodular device is paired, or on both the modular device and the surgicalhub (e.g., via a distributed computing architecture). In someexemplifications, the modular devices' control algorithms control thedevices based on data sensed by the modular device itself (i.e., bysensors in, on, or connected to the modular device). This data can berelated to the patient being operated on (e.g., tissue properties orinsufflation pressure) or the modular device itself (e.g., the rate atwhich a knife is being advanced, motor current, or energy levels). Forexample, a control algorithm for a surgical stapling and cuttinginstrument can control the rate at which the instrument's motor drivesits knife through tissue according to resistance encountered by theknife as it advances.

Situational Awareness

Situational awareness is the ability of some aspects of a surgicalsystem to determine or infer information related to a surgical procedurefrom data received from databases and/or instruments. The informationcan include the type of procedure being undertaken, the type of tissuebeing operated on, or the body cavity that is the subject of theprocedure. With the contextual information related to the surgicalprocedure, the surgical system can, for example, improve the manner inwhich it controls the modular devices (e.g. a robotic arm and/or roboticsurgical tool) that are connected to it and provide contextualizedinformation or suggestions to the surgeon during the course of thesurgical procedure.

Referring now to FIG. 46, a timeline 5200 depicting situationalawareness of a hub, such as the surgical hub 106 or 206, for example, isdepicted. The timeline 5200 is an illustrative surgical procedure andthe contextual information that the surgical hub 106, 206 can derivefrom the data received from the data sources at each step in thesurgical procedure. The timeline 5200 depicts the typical steps thatwould be taken by the nurses, surgeons, and other medical personnelduring the course of a lung segmentectomy procedure, beginning withsetting up the operating theater and ending with transferring thepatient to a post-operative recovery room.

The situationally aware surgical hub 106, 206 receives data from thedata sources throughout the course of the surgical procedure, includingdata generated each time medical personnel utilize a modular device thatis paired with the surgical hub 106, 206. The surgical hub 106, 206 canreceive this data from the paired modular devices and other data sourcesand continually derive inferences (i.e., contextual information) aboutthe ongoing procedure as new data is received, such as which step of theprocedure is being performed at any given time. The situationalawareness system of the surgical hub 106, 206 is able to, for example,record data pertaining to the procedure for generating reports, verifythe steps being taken by the medical personnel, provide data or prompts(e.g., via a display screen) that may be pertinent for the particularprocedural step, adjust modular devices based on the context (e.g.,activate monitors, adjust the field of view (FOV) of the medical imagingdevice, or change the energy level of an ultrasonic surgical instrumentor RF electrosurgical instrument), and take any other such actiondescribed above.

As the first step 5202 in this illustrative procedure, the hospitalstaff members retrieve the patient's Electronic Medical Record (EMR)from the hospital's EMR database. Based on select patient data in theEMR, the surgical hub 106, 206 determines that the procedure to beperformed is a thoracic procedure.

Second step 5204, the staff members scan the incoming medical suppliesfor the procedure. The surgical hub 106, 206 cross-references thescanned supplies with a list of supplies that are utilized in varioustypes of procedures and confirms that the mix of supplies corresponds toa thoracic procedure. Further, the surgical hub 106, 206 is also able todetermine that the procedure is not a wedge procedure (because theincoming supplies either lack certain supplies that are necessary for athoracic wedge procedure or do not otherwise correspond to a thoracicwedge procedure).

Third step 5206, the medical personnel scan the patient band via ascanner that is communicably connected to the surgical hub 106, 206. Thesurgical hub 106, 206 can then confirm the patient's identity based onthe scanned data.

Fourth step 5208, the medical staff turns on the auxiliary equipment.The auxiliary equipment being utilized can vary according to the type ofsurgical procedure and the techniques to be used by the surgeon, but inthis illustrative case they include a smoke evacuator, insufflator, andmedical imaging device. When activated, the auxiliary equipment that aremodular devices can automatically pair with the surgical hub 106, 206that is located within a particular vicinity of the modular devices aspart of their initialization process. The surgical hub 106, 206 can thenderive contextual information about the surgical procedure by detectingthe types of modular devices that pair with it during this pre-operativeor initialization phase. In this particular example, the surgical hub106, 206 determines that the surgical procedure is a VATS procedurebased on this particular combination of paired modular devices. Based onthe combination of the data from the patient's EMR, the list of medicalsupplies to be used in the procedure, and the type of modular devicesthat connect to the hub, the surgical hub 106, 206 can generally inferthe specific procedure that the surgical team will be performing. Oncethe surgical hub 106, 206 knows what specific procedure is beingperformed, the surgical hub 106, 206 can then retrieve the steps of thatprocedure from a memory or from the cloud and then cross-reference thedata it subsequently receives from the connected data sources (e.g.,modular devices and patient monitoring devices) to infer what step ofthe surgical procedure the surgical team is performing.

Fifth step 5210, the staff members attach the EKG electrodes and otherpatient monitoring devices to the patient. The EKG electrodes and otherpatient monitoring devices are able to pair with the surgical hub 106,206. As the surgical hub 106, 206 begins receiving data from the patientmonitoring devices, the surgical hub 106, 206 thus confirms that thepatient is in the operating theater.

Sixth step 5212, the medical personnel induce anesthesia in the patient.The surgical hub 106, 206 can infer that the patient is under anesthesiabased on data from the modular devices and/or patient monitoringdevices, including EKG data, blood pressure data, ventilator data, orcombinations thereof, for example. Upon completion of the sixth step5212, the pre-operative portion of the lung segmentectomy procedure iscompleted and the operative portion begins.

Seventh step 5214, the patient's lung that is being operated on iscollapsed (while ventilation is switched to the contralateral lung). Thesurgical hub 106, 206 can infer from the ventilator data that thepatient's lung has been collapsed, for example. The surgical hub 106,206 can infer that the operative portion of the procedure has commencedas it can compare the detection of the patient's lung collapsing to theexpected steps of the procedure (which can be accessed or retrievedpreviously) and thereby determine that collapsing the lung is the firstoperative step in this particular procedure.

Eighth step 5216, the medical imaging device (e.g., a scope) is insertedand video from the medical imaging device is initiated. The surgical hub106, 206 receives the medical imaging device data (i.e., video or imagedata) through its connection to the medical imaging device. Upon receiptof the medical imaging device data, the surgical hub 106, 206 candetermine that the laparoscopic portion of the surgical procedure hascommenced. Further, the surgical hub 106, 206 can determine that theparticular procedure being performed is a segmentectomy, as opposed to alobectomy (note that a wedge procedure has already been discounted bythe surgical hub 106, 206 based on data received at the second step 5204of the procedure). The data from the medical imaging device 124 (FIG.26) can be utilized to determine contextual information regarding thetype of procedure being performed in a number of different ways,including by determining the angle at which the medical imaging deviceis oriented with respect to the visualization of the patient's anatomy,monitoring the number or medical imaging devices being utilized (i.e.,that are activated and paired with the surgical hub 106, 206), andmonitoring the types of visualization devices utilized. For example, onetechnique for performing a VATS lobectomy places the camera in the loweranterior corner of the patient's chest cavity above the diaphragm,whereas one technique for performing a VATS segmentectomy places thecamera in an anterior intercostal position relative to the segmentalfissure. Using pattern recognition or machine learning techniques, forexample, the situational awareness system can be trained to recognizethe positioning of the medical imaging device according to thevisualization of the patient's anatomy. As another example, onetechnique for performing a VATS lobectomy utilizes a single medicalimaging device, whereas another technique for performing a VATSsegmentectomy utilizes multiple cameras. As yet another example, onetechnique for performing a VATS segmentectomy utilizes an infrared lightsource (which can be communicably coupled to the surgical hub as part ofthe visualization system) to visualize the segmental fissure, which isnot utilized in a VATS lobectomy. By tracking any or all of this datafrom the medical imaging device, the surgical hub 106, 206 can therebydetermine the specific type of surgical procedure being performed and/orthe technique being used for a particular type of surgical procedure.

Ninth step 5218, the surgical team begins the dissection step of theprocedure. The surgical hub 106, 206 can infer that the surgeon is inthe process of dissecting to mobilize the patient's lung because itreceives data from the RF or ultrasonic generator indicating that anenergy instrument is being fired. The surgical hub 106, 206 cancross-reference the received data with the retrieved steps of thesurgical procedure to determine that an energy instrument being fired atthis point in the process (i.e., after the completion of the previouslydiscussed steps of the procedure) corresponds to the dissection step. Incertain instances, the energy instrument can be an energy tool mountedto a robotic arm of a robotic surgical system.

Tenth step 5220, the surgical team proceeds to the ligation step of theprocedure. The surgical hub 106, 206 can infer that the surgeon isligating arteries and veins because it receives data from the surgicalstapling and cutting instrument indicating that the instrument is beingfired. Similarly to the prior step, the surgical hub 106, 206 can derivethis inference by cross-referencing the receipt of data from thesurgical stapling and cutting instrument with the retrieved steps in theprocess. In certain instances, the surgical instrument can be a surgicaltool mounted to a robotic arm of a robotic surgical system.

Eleventh step 5222, the segmentectomy portion of the procedure isperformed. The surgical hub 106, 206 can infer that the surgeon istransecting the parenchyma based on data from the surgical stapling andcutting instrument, including data from its cartridge. The cartridgedata can correspond to the size or type of staple being fired by theinstrument, for example. As different types of staples are utilized fordifferent types of tissues, the cartridge data can thus indicate thetype of tissue being stapled and/or transected. In this case, the typeof staple being fired is utilized for parenchyma (or other similartissue types), which allows the surgical hub 106, 206 to infer that thesegmentectomy portion of the procedure is being performed.

Twelfth step 5224, the node dissection step is then performed. Thesurgical hub 106, 206 can infer that the surgical team is dissecting thenode and performing a leak test based on data received from thegenerator indicating that an RF or ultrasonic instrument is being fired.For this particular procedure, an RF or ultrasonic instrument beingutilized after parenchyma was transected corresponds to the nodedissection step, which allows the surgical hub 106, 206 to make thisinference. It should be noted that surgeons regularly switch back andforth between surgical stapling/cutting instruments and surgical energy(i.e., RF or ultrasonic) instruments depending upon the particular stepin the procedure because different instruments are better adapted forparticular tasks. Therefore, the particular sequence in which thestapling/cutting instruments and surgical energy instruments are usedcan indicate what step of the procedure the surgeon is performing.Moreover, in certain instances, robotic tools can be utilized for one ormore steps in a surgical procedure and/or handheld surgical instrumentscan be utilized for one or more steps in the surgical procedure. Thesurgeon(s) can alternate between robotic tools and handheld surgicalinstruments and/or can use the devices concurrently, for example. Uponcompletion of the twelfth step 5224, the incisions are closed up and thepost-operative portion of the procedure begins.

Thirteenth step 5226, the patient's anesthesia is reversed. The surgicalhub 106, 206 can infer that the patient is emerging from the anesthesiabased on the ventilator data (i.e., the patient's breathing rate beginsincreasing), for example.

Lastly, the fourteenth step 5228 is that the medical personnel removethe various patient monitoring devices from the patient. The surgicalhub 106, 206 can thus infer that the patient is being transferred to arecovery room when the hub loses EKG, BP, and other data from thepatient monitoring devices. As can be seen from the description of thisillustrative procedure, the surgical hub 106, 206 can determine or inferwhen each step of a given surgical procedure is taking place accordingto data received from the various data sources that are communicablycoupled to the surgical hub 106, 206.

Situational awareness is further described in U.S. Provisional PatentApplication Ser. No. 62/611,341, titled INTERACTIVE SURGICAL PLATFORM,filed Dec. 28, 2017, the disclosure of which is herein incorporated byreference in its entirety. In certain instances, operation of a roboticsurgical system, including the various robotic surgical systemsdisclosed herein, for example, can be controlled by the hub 106, 206based on its situational awareness and/or feedback from the componentsthereof and/or based on information from the cloud 104.

EXAMPLES

Various aspects of the subject matter described herein are set out inthe following numbered examples.

Example 1

A surgical hub, comprising: a control circuit, the control circuitincluding a plurality of segments; the plurality of segments including afirst segment, a second segment, and a third segment; the first segmentincludes a main processor and a safety processor, wherein the mainprocessor is coupled to a memory, and the memory stores instructionsexecutable by the main processor to energize the first segment beforethe second and third segment, energizing the second and third segmentsafter the first segment performs a first function; the second segmentincludes a sensing circuit and a display circuit; and the third segmentincluding a motor control circuit and a motor.

Example 2

The surgical hub of Example 1, wherein the first function is checkingthe first, second, and third segments for at least one of a shortcircuit and an error.

Example 3

The surgical hub of any one of Examples 1-2, wherein the first functionis performing a safety check on the first, second, and third segments.

Example 4

The surgical hub of any one of Examples 1-3, wherein the first functionis verifying the sensing circuit, the display circuit, the motor controlcircuit, and the motor are correct components.

Example 5

The surgical hub of any one of Examples 1-4, wherein the control circuitidentifies the main processor, the safety processor, the sensingcircuit, the display circuit, the motor control circuit, and the motor,and displays on a display device a status of the main processor, thesafety processor, the sensing circuit, the display circuit, the motorcontrol circuit, and the motor.

Example 6

The surgical hub of any one of Examples 1-5, wherein the control circuitidentifies the first segment, the second segment and the third segment,and displays on a display device a status to a user of the firstsegment, the second segment, and the third segment.

Example 7

The surgical hub of any one of Examples 1-6, further comprising a pumpcoupled to the motor.

Example 8

The surgical hub of any one of Examples 1-7, wherein the motor operatesat a first state or a second state.

Example 9

The surgical hub of any one of Examples 1-8, wherein the first state isactivated by a user, and the motor causes the pump to operate at a firstrate.

Example 10

The surgical hub of any one of Examples 1-9, wherein the motor causesthe pump to operate at a second rate in the second state.

Example 11

A method of operating a segmented control circuit in a surgicalevacuation system, comprising: activating a first segment, wherein thefirst segment includes a main processor and a safety processor; causingthe first segment to perform a first function; activating a secondsegment, wherein the second segment includes a sensing circuit and adisplay circuit; and activating a third segment, wherein the thirdsegment includes a motor control circuit and a motor.

Example 12

The method of operating the segmented control circuit of Example 11,wherein the first function is checking the first, second, and thirdsegments for at least one of a short circuit and an error.

Example 13

The method of operating the segmented control circuit of any one ofExamples 11-12, wherein the first function is performing a safety checkon the first, second, and third segments.

Example 14

The method of operating the segmented control circuit of any one ofExamples 11-13, wherein the first function is verifying the sensingcircuit, the display circuit, the motor control circuit, and the motorare correct components.

Example 15

The method of operating the segmented control circuit of any one ofExamples 11-14, further comprising: identifying, by the control circuit,the main processor, the safety processor, the sensing circuit, thedisplay circuit, the motor control circuit, and the motor; anddisplaying on a display device a status of the main processor, thesafety processor, the sensing circuit, the display circuit, the motorcontrol circuit, and the motor.

Example 16

The method of operating the segmented control circuit of any one ofExamples 11-15, further comprising: identifying, by the control circuit,the first segment, the second segment, and the third segment; anddisplaying on a display device a status of the first segment, the secondsegment, and the third segment.

Example 17

The method of operating the segmented control circuit of any one ofExamples 11-16, further comprising: operating the motor at a first stateor a second state.

Example 18

The method of operating the segmented control circuit of any one ofExamples 11-17, wherein the first state is activated by a user, wherethe motor causes the pump to operate at a first rate.

Example 19

The method of operating the segmented control circuit of any one ofExamples 11-18, wherein the motor causes the pump to operate at a secondrate in the second state.

Example 20

A non-transitory computer-readable medium storing computer readableinstructions, which when executed cause a machine to: activate a firstsegment, wherein the first segment includes a main processor and asafety processor; cause the first segment to perform a first function;activate a second segment, wherein the second segment includes a sensingcircuit and a display circuit; and activate a third segment, wherein thethird segment includes a motor control circuit and a motor.

Example 21

A surgical evacuation system comprising a control circuit, the controlcircuit including a plurality of segments; the plurality of segmentsincluding a first segment, a second segment, and a third segment; thefirst segment includes a main processor and a safety processor, whereinthe main processor is coupled to a memory, and the memory storesinstructions executable by the main processor to energize the firstsegment before the second and third segment, energizing the second andthird segments after the first segment performs a first function; thesecond segment includes a sensing circuit and a display circuit; and thethird segment including a motor control circuit and a motor.

Example 22

The surgical evacuation system of Example 21, wherein the first functionis checking the first, second, and third segments for at least one of ashort circuit and an error.

Example 23

The surgical evacuation system of any one of Examples 21-22, wherein thefirst function is performing a safety check on the first, second, andthird segments.

Example 24

The surgical evacuation system of any one of Examples 21-23, wherein thefirst function is verifying the sensing circuit, the display circuit,the motor control circuit, and the motor are the correct components.

Example 25

The surgical evacuation system of any one of Examples 21-24, wherein thecontrol circuit identifies the main processor, the safety processor, thesensing circuit, the display circuit, the motor control circuit, and themotor, and displays on a display device a status of the main processor,the safety processor, the sensing circuit, the display circuit, themotor control circuit, and the motor.

Example 26

The surgical evacuation system of any one of Examples 21-25, wherein thecontrol circuit identifies the first segment, the second segment and thethird segment, and displays on a display device a status to a user ofthe first segment, the second segment, and the third segment.

Example 27

The surgical evacuation system of any one of Examples 21-26, furthercomprising a pump coupled to the motor.

Example 28

The surgical evacuation system of any one of Examples 21-27, wherein themotor operates at a first state or a second state.

Example 29

The surgical evacuation system of Example 28, wherein the first state isactivated by a user, and the motor causes the pump to operate at a rapidrate.

Example 30

The surgical evacuation any one of Examples 28-29, wherein the secondstate is a slow state, where the motor causes the pump to operate at aslower rate.

Example 31

A method of operating a segmented control circuit in a surgicalevacuation system, comprising activating a first segment, wherein thefirst segment includes a main processor and a safety processor; causingthe first segment to perform a first function; activating a secondsegment, wherein the second segment includes a sensing circuit and adisplay circuit; and activating a third segment, wherein the thirdsegment includes a motor control circuit and a motor.

Example 32

The method of operating the segmented control circuit of Example 31,wherein the first function is checking the first, second, and thirdsegments for at least one of a short circuit and an error.

Example 33

The method of operating the segmented control circuit of any one ofExamples 31-32, wherein the first function is performing a safety checkon the first, second, and third segments.

Example 34

The method of operating the segmented control circuit of any one ofExamples 31-33, wherein the first function is verifying the sensingcircuit, the display circuit, the motor control circuit, and the motorare the correct components.

Example 35

The method of operating the segmented control circuit of any one ofExamples 31-34, further comprising: identifying, by the control circuit,the main processor, the safety processor, the sensing circuit, thedisplay circuit, the motor control circuit, and the motor; anddisplaying on a display device a status of the main processor, thesafety processor, the sensing circuit, the display circuit, the motorcontrol circuit, and the motor.

Example 36

The method of operating the segmented control circuit of any one ofExample 31-35, further comprising identifying, by the control circuit,the first segment, the second segment, and the third segment; anddisplaying on a display device a status of the first segment, the secondsegment, and the third segment.

Example 37

The method of operating the segmented control circuit of any one ofExamples 31-36, wherein a pump is coupled to the motor.

Example 38

The method of operating the segmented control circuit of Example 37,further comprising operating the motor at a first state or a secondstate.

Example 39

The method of operating the segmented control circuit of Example 38,wherein the first state is activated by a user, where the motor causesthe pump to operate at a rapid rate.

Example 40

The method of operating the segmented control circuit of any one ofExamples 38-39, wherein the second state is a slow state, where themotor causes the pump to operate at a slower rate.

Example 41

A surgical hub comprising a processor and a memory coupled to theprocessor, the memory storing instructions executable by the processorto perform the method described in any one of Examples 31-40.

Example 42

A non-transitory computer-readable medium storing computer readableinstructions, which when executed cause a machine to perform the methoddescribed in any one of Examples 31-40.

Example 43

The method of operating the segmented control circuit of Example 38,wherein the first state is activated by a user, where the motor causesthe pump to operate at a first rate.

Example 44

The method of operating the segmented control circuit of Example 38,wherein the motor causes the pump to operate at a second rate in thesecond state.

Example 45

A non-transitory computer-readable medium storing computer readableinstructions, which when executed cause a machine to: activate a firstsegment, wherein the first segment includes a main processor and asafety processor; cause the first segment to perform a first function;activate a second segment, wherein the second segment includes a sensingcircuit and a display circuit; and activate a third segment, wherein thethird segment includes a motor control circuit and a motor.

While several forms have been illustrated and described, it is not theintention of the applicant to restrict or limit the scope of theappended claims to such detail. Numerous modifications, variations,changes, substitutions, combinations, and equivalents to those forms maybe implemented and will occur to those skilled in the art withoutdeparting from the scope of the present disclosure. Moreover, thestructure of each element associated with the described forms can bealternatively described as a means for providing the function performedby the element. Also, where materials are disclosed for certaincomponents, other materials may be used. It is therefore to beunderstood that the foregoing description and the appended claims areintended to cover all such modifications, combinations, and variationsas falling within the scope of the disclosed forms. The appended claimsare intended to cover all such modifications, variations, changes,substitutions, modifications, and equivalents.

The foregoing detailed description has set forth various forms of thedevices and/or processes via the use of block diagrams, flowcharts,and/or examples. Insofar as such block diagrams, flowcharts, and/orexamples contain one or more functions and/or operations, it will beunderstood by those within the art that each function and/or operationwithin such block diagrams, flowcharts, and/or examples can beimplemented, individually and/or collectively, by a wide range ofhardware, software, firmware, or virtually any combination thereof.Those skilled in the art will recognize that some aspects of the formsdisclosed herein, in whole or in part, can be equivalently implementedin integrated circuits, as one or more computer programs running on oneor more computers (e.g., as one or more programs running on one or morecomputer systems), as one or more programs running on one or moreprocessors (e.g., as one or more programs running on one or moremicroprocessors), as firmware, or as virtually any combination thereof,and that designing the circuitry and/or writing the code for thesoftware and or firmware would be well within the skill of one of skillin the art in light of this disclosure. In addition, those skilled inthe art will appreciate that the mechanisms of the subject matterdescribed herein are capable of being distributed as one or more programproducts in a variety of forms, and that an illustrative form of thesubject matter described herein applies regardless of the particulartype of signal bearing medium used to actually carry out thedistribution.

Instructions used to program logic to perform various disclosed aspectscan be stored within a memory in the system, such as dynamic randomaccess memory (DRAM), cache, flash memory, or other storage.Furthermore, the instructions can be distributed via a network or by wayof other computer readable media. Thus a machine-readable medium mayinclude any mechanism for storing or transmitting information in a formreadable by a machine (e.g., a computer), but is not limited to, floppydiskettes, optical disks, compact disc, read-only memory (CD-ROMs), andmagneto-optical disks, read-only memory (ROMs), random access memory(RAM), erasable programmable read-only memory (EPROM), electricallyerasable programmable read-only memory (EEPROM), magnetic or opticalcards, flash memory, or a tangible, machine-readable storage used in thetransmission of information over the Internet via electrical, optical,acoustical or other forms of propagated signals (e.g., carrier waves,infrared signals, digital signals, etc.). Accordingly, thenon-transitory computer-readable medium includes any type of tangiblemachine-readable medium suitable for storing or transmitting electronicinstructions or information in a form readable by a machine (e.g., acomputer).

As used in any aspect herein, the term “control circuit” may refer to,for example, hardwired circuitry, programmable circuitry (e.g., acomputer processor comprising one or more individual instructionprocessing cores, processing unit, processor, microcontroller,microcontroller unit, controller, digital signal processor (DSP),programmable logic device (PLD), programmable logic array (PLA), orfield programmable gate array (FPGA)), state machine circuitry, firmwarethat stores instructions executed by programmable circuitry, and anycombination thereof. The control circuit may, collectively orindividually, be embodied as circuitry that forms part of a largersystem, for example, an integrated circuit (IC), an application-specificintegrated circuit (ASIC), a system on-chip (SoC), desktop computers,laptop computers, tablet computers, servers, smart phones, etc.Accordingly, as used herein “control circuit” includes, but is notlimited to, electrical circuitry having at least one discrete electricalcircuit, electrical circuitry having at least one integrated circuit,electrical circuitry having at least one application specific integratedcircuit, electrical circuitry forming a general purpose computing deviceconfigured by a computer program (e.g., a general purpose computerconfigured by a computer program which at least partially carries outprocesses and/or devices described herein, or a microprocessorconfigured by a computer program which at least partially carries outprocesses and/or devices described herein), electrical circuitry forminga memory device (e.g., forms of random access memory), and/or electricalcircuitry forming a communications device (e.g., a modem, communicationsswitch, or optical-electrical equipment). Those having skill in the artwill recognize that the subject matter described herein may beimplemented in an analog or digital fashion or some combination thereof.

As used in any aspect herein, the term “logic” may refer to an app,software, firmware and/or circuitry configured to perform any of theaforementioned operations. Software may be embodied as a softwarepackage, code, instructions, instruction sets and/or data recorded onnon-transitory computer readable storage medium. Firmware may beembodied as code, instructions or instruction sets and/or data that arehard-coded (e.g., nonvolatile) in memory devices.

As used in any aspect herein, the terms “component,” “system,” “module”and the like can refer to a computer-related entity, either hardware, acombination of hardware and software, software, or software inexecution.

As used in any aspect herein, an “algorithm” refers to a self-consistentsequence of steps leading to a desired result, where a “step” refers toa manipulation of physical quantities and/or logic states which may,though need not necessarily, take the form of electrical or magneticsignals capable of being stored, transferred, combined, compared, andotherwise manipulated. It is common usage to refer to these signals asbits, values, elements, symbols, characters, terms, numbers, or thelike. These and similar terms may be associated with the appropriatephysical quantities and are merely convenient labels applied to thesequantities and/or states.

A network may include a packet switched network. The communicationdevices may be capable of communicating with each other using a selectedpacket switched network communications protocol. One examplecommunications protocol may include an Ethernet communications protocolwhich may be capable permitting communication using a TransmissionControl Protocol/Internet Protocol (TCP/IP). The Ethernet protocol maycomply or be compatible with the Ethernet standard published by theInstitute of Electrical and Electronics Engineers (IEEE) titled “IEEE802.3 Standard”, published in December, 2008 and/or later versions ofthis standard. Alternatively or additionally, the communication devicesmay be capable of communicating with each other using an X.25communications protocol. The X.25 communications protocol may comply orbe compatible with a standard promulgated by the InternationalTelecommunication Union-Telecommunication Standardization Sector(ITU-T). Alternatively or additionally, the communication devices may becapable of communicating with each other using a frame relaycommunications protocol. The frame relay communications protocol maycomply or be compatible with a standard promulgated by ConsultativeCommittee for International Telegraph and Telephone (CCITT) and/or theAmerican National Standards Institute (ANSI). Alternatively oradditionally, the transceivers may be capable of communicating with eachother using an Asynchronous Transfer Mode (ATM) communications protocol.The ATM communications protocol may comply or be compatible with an ATMstandard published by the ATM Forum titled “ATM-MPLS NetworkInterworking 2.0” published August 2001, and/or later versions of thisstandard. Of course, different and/or after-developedconnection-oriented network communication protocols are equallycontemplated herein.

Unless specifically stated otherwise as apparent from the foregoingdisclosure, it is appreciated that, throughout the foregoing disclosure,discussions using terms such as “processing,” “computing,”“calculating,” “determining,” “displaying,” or the like, refer to theaction and processes of a computer system, or similar electroniccomputing device, that manipulates and transforms data represented asphysical (electronic) quantities within the computer system's registersand memories into other data similarly represented as physicalquantities within the computer system memories or registers or othersuch information storage, transmission or display devices.

One or more components may be referred to herein as “configured to,”“configurable to,” “operable/operative to,” “adapted/adaptable,” “ableto,” “conformable/conformed to,” etc. Those skilled in the art willrecognize that “configured to” can generally encompass active-statecomponents and/or inactive-state components and/or standby-statecomponents, unless context requires otherwise.

The terms “proximal” and “distal” are used herein with reference to aclinician manipulating the handle portion of the surgical instrument.The term “proximal” refers to the portion closest to the clinician andthe term “distal” refers to the portion located away from the clinician.It will be further appreciated that, for convenience and clarity,spatial terms such as “vertical”, “horizontal”, “up”, and “down” may beused herein with respect to the drawings. However, surgical instrumentsare used in many orientations and positions, and these terms are notintended to be limiting and/or absolute.

Those skilled in the art will recognize that, in general, terms usedherein, and especially in the appended claims (e.g., bodies of theappended claims) are generally intended as “open” terms (e.g., the term“including” should be interpreted as “including but not limited to,” theterm “having” should be interpreted as “having at least,” the term“includes” should be interpreted as “includes but is not limited to,”etc.). It will be further understood by those within the art that if aspecific number of an introduced claim recitation is intended, such anintent will be explicitly recited in the claim, and in the absence ofsuch recitation no such intent is present. For example, as an aid tounderstanding, the following appended claims may contain usage of theintroductory phrases “at least one” and “one or more” to introduce claimrecitations. However, the use of such phrases should not be construed toimply that the introduction of a claim recitation by the indefinitearticles “a” or “an” limits any particular claim containing suchintroduced claim recitation to claims containing only one suchrecitation, even when the same claim includes the introductory phrases“one or more” or “at least one” and indefinite articles such as “a” or“an” (e.g., “a” and/or “an” should typically be interpreted to mean “atleast one” or “one or more”); the same holds true for the use ofdefinite articles used to introduce claim recitations.

In addition, even if a specific number of an introduced claim recitationis explicitly recited, those skilled in the art will recognize that suchrecitation should typically be interpreted to mean at least the recitednumber (e.g., the bare recitation of “two recitations,” without othermodifiers, typically means at least two recitations, or two or morerecitations). Furthermore, in those instances where a conventionanalogous to “at least one of A, B, and C, etc.” is used, in generalsuch a construction is intended in the sense one having skill in the artwould understand the convention (e.g., “a system having at least one ofA, B, and C” would include but not be limited to systems that have Aalone, B alone, C alone, A and B together, A and C together, B and Ctogether, and/or A, B, and C together, etc.). In those instances where aconvention analogous to “at least one of A, B, or C, etc.” is used, ingeneral such a construction is intended in the sense one having skill inthe art would understand the convention (e.g., “a system having at leastone of A, B, or C” would include but not be limited to systems that haveA alone, B alone, C alone, A and B together, A and C together, B and Ctogether, and/or A, B, and C together, etc.). It will be furtherunderstood by those within the art that typically a disjunctive wordand/or phrase presenting two or more alternative terms, whether in thedescription, claims, or drawings, should be understood to contemplatethe possibilities of including one of the terms, either of the terms, orboth terms unless context dictates otherwise. For example, the phrase “Aor B” will be typically understood to include the possibilities of “A”or “B” or “A and B.”

With respect to the appended claims, those skilled in the art willappreciate that recited operations therein may generally be performed inany order. Also, although various operational flow diagrams arepresented in a sequence(s), it should be understood that the variousoperations may be performed in other orders than those which areillustrated, or may be performed concurrently. Examples of suchalternate orderings may include overlapping, interleaved, interrupted,reordered, incremental, preparatory, supplemental, simultaneous,reverse, or other variant orderings, unless context dictates otherwise.Furthermore, terms like “responsive to,” “related to,” or otherpast-tense adjectives are generally not intended to exclude suchvariants, unless context dictates otherwise.

It is worthy to note that any reference to “one aspect,” “an aspect,”“an exemplification,” “one exemplification,” and the like means that aparticular feature, structure, or characteristic described in connectionwith the aspect is included in at least one aspect. Thus, appearances ofthe phrases “in one aspect,” “in an aspect,” “in an exemplification,”and “in one exemplification” in various places throughout thespecification are not necessarily all referring to the same aspect.Furthermore, the particular features, structures or characteristics maybe combined in any suitable manner in one or more aspects.

Any patent application, patent, non-patent publication, or otherdisclosure material referred to in this specification and/or listed inany Application Data Sheet is incorporated by reference herein, to theextent that the incorporated materials is not inconsistent herewith. Assuch, and to the extent necessary, the disclosure as explicitly setforth herein supersedes any conflicting material incorporated herein byreference. Any material, or portion thereof, that is said to beincorporated by reference herein, but which conflicts with existingdefinitions, statements, or other disclosure material set forth hereinwill only be incorporated to the extent that no conflict arises betweenthat incorporated material and the existing disclosure material.

In summary, numerous benefits have been described which result fromemploying the concepts described herein. The foregoing description ofthe one or more forms has been presented for purposes of illustrationand description. It is not intended to be exhaustive or limiting to theprecise form disclosed. Modifications or variations are possible inlight of the above teachings. The one or more forms were chosen anddescribed in order to illustrate principles and practical application tothereby enable one of ordinary skill in the art to utilize the variousforms and with various modifications as are suited to the particular usecontemplated. It is intended that the claims submitted herewith definethe overall scope.

What is claimed is:
 1. A surgical hub, comprising: a control circuit,the control circuit including a plurality of segments; the plurality ofsegments including a first segment, a second segment, and a thirdsegment; the first segment includes a main processor and a safetyprocessor, wherein the main processor is coupled to a memory, and thememory stores instructions executable by the main processor to energizethe first segment before the second and third segment, energizing thesecond and third segments after the first segment performs a firstfunction; the second segment includes a sensing circuit and a displaycircuit; and the third segment including a motor control circuit and amotor.
 2. The surgical hub of claim 1, wherein the first function ischecking the first, second, and third segments for at least one of ashort circuit and an error.
 3. The surgical hub of claim 1, wherein thefirst function is performing a safety check on the first, second, andthird segments.
 4. The surgical hub of claim 1, wherein the firstfunction is verifying the sensing circuit, the display circuit, themotor control circuit, and the motor are correct components.
 5. Thesurgical hub of claim 1, wherein the control circuit identifies the mainprocessor, the safety processor, the sensing circuit, the displaycircuit, the motor control circuit, and the motor, and displays on adisplay device a status of the main processor, the safety processor, thesensing circuit, the display circuit, the motor control circuit, and themotor.
 6. The surgical hub of claim 1, wherein the control circuitidentifies the first segment, the second segment and the third segment,and displays on a display device a status to a user of the firstsegment, the second segment, and the third segment.
 7. The surgical hubof claim 1, further comprising a pump coupled to the motor.
 8. Thesurgical hub of claim 1, wherein the motor operates at a first state ora second state.
 9. The surgical hub of claim 8, wherein the first stateis activated by a user, and the motor causes the pump to operate at afirst rate.
 10. The surgical hub of claim 8, wherein the motor causesthe pump to operate at a second rate in the second state.
 11. A methodof operating a segmented control circuit in a surgical evacuationsystem, comprising: activating a first segment, wherein the firstsegment includes a main processor and a safety processor; causing thefirst segment to perform a first function; activating a second segment,wherein the second segment includes a sensing circuit and a displaycircuit; and activating a third segment, wherein the third segmentincludes a motor control circuit and a motor.
 12. The method ofoperating the segmented control circuit of claim 11, wherein the firstfunction is checking the first, second, and third segments for at leastone of a short circuit and an error.
 13. The method of operating thesegmented control circuit of claim 11, wherein the first function isperforming a safety check on the first, second, and third segments. 14.The method of operating the segmented control circuit of claim 11,wherein the first function is verifying the sensing circuit, the displaycircuit, the motor control circuit, and the motor are correctcomponents.
 15. The method of operating the segmented control circuit ofclaim 11, further comprising: identifying, by the control circuit, themain processor, the safety processor, the sensing circuit, the displaycircuit, the motor control circuit, and the motor; and displaying on adisplay device a status of the main processor, the safety processor, thesensing circuit, the display circuit, the motor control circuit, and themotor.
 16. The method of operating the segmented control circuit ofclaim 11, further comprising: identifying, by the control circuit, thefirst segment, the second segment, and the third segment; and displayingon a display device a status of the first segment, the second segment,and the third segment.
 17. The method of operating the segmented controlcircuit of claim 17, further comprising: operating the motor at a firststate or a second state.
 18. The method of operating the segmentedcontrol circuit of claim 18, wherein the first state is activated by auser, where the motor causes the pump to operate at a first rate. 19.The method of operating the segmented control circuit of claim 18,wherein the motor causes the pump to operate at a second rate in thesecond state.
 20. A non-transitory computer-readable medium storingcomputer readable instructions, which when executed cause a machine to:activate a first segment, wherein the first segment includes a mainprocessor and a safety processor; cause the first segment to perform afirst function; activate a second segment, wherein the second segmentincludes a sensing circuit and a display circuit; and activate a thirdsegment, wherein the third segment includes a motor control circuit anda motor.